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Angiographic characteristics and treatment approach in patients undergoing intra-arterial chemotherapy for retinoblastoma

  • Oncology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To identify the specific clinical and angiographic variables that determine the success of intra-arterial chemotherapy (IAC) in a patient with retinoblastoma.

Methods

Medical records from patients undergoing intra-arterial chemotherapy for the treatment of retinoblastoma between January 2015 and June 2020 within a large academic ocular oncology practice were retrospectively reviewed. Demographics were recorded together with clinical, ocular, and angiographic variables such as the diameter of the ophthalmic artery (OA), angle of ophthalmic artery takeoff, and branching pattern of ophthalmic vasculature.

Results

Forty-four eyes from 33 patients with retinoblastoma treated with IAC were identified. Over the total 32 mean months of follow-up, these patients received 144 total catheterizations and a mean of 3.2 IAC cycles for each eye. The number of IAC cycles and the chemotherapeutic agent used did not vary significantly with worsening International Classification of Retinoblastoma (ICRB) groups (P > 0.1). Cumulative dose did not vary with the ICRB group for eyes treated with melphalan, topotecan, or carboplatin (P > 0.1). A higher ICRB group was associated with a smaller mean ophthalmic artery diameter across all procedures (P = 0.016), and femoral artery diameter did not vary significantly between ICRB groups (P = 0.906). A higher cumulative dose of IAC was significantly associated with a smaller takeoff angle of the OA (melphalan, P = 0.011; topotecan, P = 0.009; carboplatin, P = 0.031) in patients who underwent successful IAC procedures. Ophthalmic artery diameter and femoral artery diameter did not have a significant association (P > 0.1) with higher IAC doses in successful IACs. Cumulative IAC dose was not significantly associated with ophthalmic vasculature branching pattern, presence of choroidal blush, temporary OA vasospasm reported during the procedure, and OA occlusion upon microcatheter placement.

Conclusion

In this study, neurosurgical angioanatomy appeared to influence the cumulative dose of chemotherapy needed during IAC for retinoblastoma. In the future, these anatomic variables may be used to guide the frequency of monitoring, dosing, and estimation of recurrence risk.

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Authors and Affiliations

  1. Retina Consultants of Texas, Houston, TX, USA

    Alexander M. Rusakevich, Brenda Zhou, Maria E. Bretana & Amy C. Schefler

  2. University of Texas Health Science Center at Houston, 6560 Fannin St., Suite 750, Houston, TX, 77030, USA

    Michael I. Nahhas, Mark J. Dannenbaum & Amy C. Schefler

Authors
  1. Alexander M. Rusakevich
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  2. Michael I. Nahhas
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  3. Brenda Zhou
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  4. Mark J. Dannenbaum
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  5. Maria E. Bretana
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  6. Amy C. Schefler
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by AR, MN, BZ, and MB. The first draft of the manuscript was written by AR and AS. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Amy C. Schefler.

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Ethical compliance

Institutional review board (Houston Methodist Hospital, Houston, Texas; University of Texas Health Science Center at Houston) approval for chart review was obtained. All study procedures adhered to the tenets set forth in the Declaration of Helsinki and the Health Insurance Portability and Accountability Act.

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The authors declare no competing interests.

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Rusakevich, A.M., Nahhas, M.I., Zhou, B. et al. Angiographic characteristics and treatment approach in patients undergoing intra-arterial chemotherapy for retinoblastoma. Graefes Arch Clin Exp Ophthalmol 262, 1321–1328 (2024). https://doi.org/10.1007/s00417-023-06279-8

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  • DOI: https://doi.org/10.1007/s00417-023-06279-8

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