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The Use of Alternative Routes for the Delivery of Intra-Arterial Chemotherapy for Retinoblastoma
- Source :
- Neurosurgery. 87:956-963
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Background The introduction of intra-arterial chemotherapy (IAC) for treatment of retinoblastoma considerably changed the paradigm by which this disease is managed, with event-free survival rates being above 70%. Objective To analyze efficacy of IAC treatment using alternative approaches to ophthalmic artery catheterization (OAC), such as external carotid artery approach or balloon-assisted drug delivery. Methods This is a retrospective chart review for subjects receiving IAC for retinoblastoma. The primary approach was OAC. In cases in which selective OAC was not feasible, alternative routes including catheterization of the external carotid artery or use of a balloon-assisted drug infusion were used. Results This study included 197 consecutive patients with 207 retinoblastomas who underwent 658 IAC procedures overall. The mean age at diagnosis was 24 mo, and 54.5% of the study population was male. Success rate with IAC was 97% (639). Alternative approaches to OAC were, in total, 42 cases (6.4%)-external carotid artery catheterization and use of ICA balloon were performed in 22 (3.3%) and 20 (3%) cases, respectively. A mean of 3.1 IAC cycles were performed for each patient. In total, there were 23 technical failures of the primary OAC technique (3.4%). Periprocedural adverse events occurred in 4 procedures (0.6%). Use of an alternative technique for chemotherapy delivery other than selective OAC in at least one IAC cycle was not a predictor of enucleation. Conclusion IAC is a safe and effective treatment option for retinoblastoma. Chemotherapy delivery using alternative techniques is as effective as selective OAC.
- Subjects :
- Male
medicine.medical_specialty
Retinal Neoplasms
medicine.medical_treatment
Middle meningeal artery
Enucleation
External carotid artery
Antineoplastic Agents
Balloon
Catheterization
Ophthalmic Artery
03 medical and health sciences
Drug Delivery Systems
0302 clinical medicine
medicine.artery
Humans
Infusions, Intra-Arterial
Medicine
Adverse effect
Retrospective Studies
Chemotherapy
business.industry
Retinoblastoma
Infant
Chemotherapy regimen
Surgery
Treatment Outcome
Child, Preschool
Ophthalmic artery
Carotid Artery, External
030221 ophthalmology & optometry
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15244040 and 0148396X
- Volume :
- 87
- Database :
- OpenAIRE
- Journal :
- Neurosurgery
- Accession number :
- edsair.doi.dedup.....901bf325b3cd907cae0cdd1169fdc14a