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Intra-arterial chemotherapy for retinoblastoma in Australia: 11-year experience
  • +13
  • Yuanzhang Jiao,
  • Roderick O'Day,
  • Anu Mathew,
  • James Elder,
  • John McKenzie,
  • MIchael Sullivan,
  • Marty Campbell,
  • Peter Mitchell,
  • John Vrazas,
  • Elhamy Bekhit,
  • Glen Gole,
  • Michael Jones,
  • Jayne Camuglia,
  • David Sia,
  • Jaclyn White,
  • Sandra Staffieri
Yuanzhang Jiao
University Hospital Geelong

Corresponding Author:jackj1786@gmail.com

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Roderick O'Day
The Royal Children's Hospital Melbourne
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Anu Mathew
The Royal Children's Hospital Melbourne
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James Elder
The Royal Children's Hospital Melbourne
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John McKenzie
The Royal Children's Hospital Melbourne
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MIchael Sullivan
The Royal Children's Hospital
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Marty Campbell
Royal Children's Hospital Melbourne
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Peter Mitchell
The Royal Melbourne Hospital City Campus
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John Vrazas
The Royal Children's Hospital Melbourne
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Elhamy Bekhit
The Royal Children's Hospital Melbourne
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Glen Gole
Queensland Children's Hospital
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Michael Jones
Children's Hospital at Westmead
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Jayne Camuglia
Queensland Children's Hospital
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David Sia
Women's and Children's Hospital Adelaide
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Jaclyn White
Queensland Children's Hospital
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Sandra Staffieri
The Royal Children's Hospital Melbourne
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Abstract

Background: Intra-arterial chemotherapy (IAC) is increasingly used in managing patients with retinoblastoma. In Australia, IAC is primarily used as a globe-salvage treatment when primary treatment has failed. Methods: A retrospective, single-institution study conducted on consecutive children treated with IAC at the Royal Children’s Hospital, Victoria, Australia between September 2009 to January 2021. Results: Using the Intraocular Classification of Retinoblastoma (ICRB), 16 eyes of 14 children classified as group A (n=1), Group B (n=3), Group D (n=10), or Group E (n=2) were treated with IAC. All but one child received IAC as secondary treatment for relapsed or refractory disease. Successful catheterisation of the ophthalmic artery was achieved in 37/46 (80.4%) procedures. A systemic complication occurred in one child (n=1): radiological evidence of a watershed infarct. Local complications of IAC included conjunctival injection (n=1), forehead rash (n=1), sixth cranial nerve palsy (n=2), ptosis (n=2), hemi-retinal ischaemia (n=1), choroidal ischaemia (n=1), retinal detachment (n=2), and choroidal neovascularisation (n=1). Regional extra-ocular disease occurred in one child. No child had distant metastatic disease and no child died. The overall globe salvage rate was 8/16 (50%): Group A (n=1, 100%), group B (n=2, 66.6%), Group D (n=5, 50%), group E (n=0, 0%). Kaplan Meier analysis of ocular survival following treatment with IAC was 75%, 68% and 53% for 6 months, 1 year and 2 years, respectively. Conclusions: Our experience demonstrates that IAC can be a useful treatment modality for refractory retinoblastoma in globe salvage, with an acceptable side-effect profile.