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Clinical Sciences
June 13, 2011

Intra-arterial Chemotherapy for the Management of Retinoblastoma: Four-Year Experience

Author Affiliations

Author Affiliations: Interventional Neuroradiology, Departments of Radiology and Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital (Dr Gobin), Department of Pediatrics (Dr Dunkel) and Ophthalmic Oncology Service (Drs Marr, Brodie, and Abramson), Memorial Sloan-Kettering Cancer Center, and Department of Ophthalmology, Mount Sinai School of Medicine (Dr Brodie), New York, New York.

Arch Ophthalmol. 2011;129(6):732-737. doi:10.1001/archophthalmol.2011.5

Enucleation remains the most common treatment for advanced intraocular retinoblastoma (Reese-Ellsworth [RE] group V), although some eyes can be salvaged with combinations of systemic chemotherapy, focal techniques, and external beam radiation (EBR) therapy.1-3 In 1955, Reese et al4 was the first to describe intra-arterial (IA) chemotherapy for retinoblastoma by “instillation under direct observation into the internal carotid artery on the side of the involved eye.” However, it was not until 1993 that Mohri5 reported using IA chemotherapy routinely with a technique of semi-selective IA infusion.5-7

Inspired by the Japanese experience, in May 2006, we started performing selective chemotherapy by direct intraophthalmic artery catheterization using modern microcatheters. In our early experience, we showed that IA chemotherapy could be successful in avoiding enucleation in advanced retinoblastoma, with acceptable ocular toxicity and minimal systemic toxicity,8-10 and that many treated eyes could retain or even improve retinal function.11 We subsequently expanded our indications for IA chemotherapy to allow its use as a primary treatment.12 Herein, we report our entire 4-year experience with IA chemotherapy for intraocular retinoblastoma.