PT  - JOURNAL ARTICLE
AU  - Sweid, A.
AU  - Hammoud, B.
AU  - Weinberg, J.H.
AU  - Texakalidis, P.
AU  - Xu, V.
AU  - Shivashankar, K.
AU  - Baldassari, M.P.
AU  - Das, S.
AU  - Ramesh, S.
AU  - Tjoumakaris, S.
AU  - Shields, C.L.
AU  - Ancona-Lezama, D.
AU  - Lim, L.-A.S.
AU  - Dalvin, L.A.
AU  - Jabbour, P.
TI  - Intra-Arterial Chemotherapy for Retinoblastoma in Infants ≤10 kg: 74 Treated Eyes with 222 IAC Sessions
AID  - 10.3174/ajnr.A6590
DP  - 2020 Jun 25
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2020/06/25/ajnr.A6590.short
4100  - http://www.ajnr.org/content/early/2020/06/25/ajnr.A6590.full
AB  - BACKGROUND AND PURPOSE: Intra-arterial chemotherapy for retinoblastoma has dramatically altered the natural history of the disease. The remarkable outcomes associated with a high safety profile have pushed the envelope to offer treatment for patients weighing ≤10 kg. The purpose was to determine the efficacy and safety of IAC infusions performed in infants weighing ≤10 kg with intraocular retinoblastoma.MATERIALS AND METHODS: A retrospective chart review was performed for patients diagnosed with retinoblastoma and managed with intra-arterial chemotherapy.RESULTS: The total study cohort included 207 retinoblastoma tumors of 207 eyes in 196 consecutive patients who underwent 658 intra-arterial chemotherapy infusions overall. Of these, patient weights were ≤10 kg in 69 (35.2%) and >10 kg in 127 (64.8%) patients. Comparison (≤10 kg versus >10 kg) revealed that the total number of intra-arterial chemotherapy infusions was 222 versus 436. Periprocedural complications were not significantly different (2 [0.9%] versus 2 [0.5%]; P = .49). Cumulative radiation exposure per eye was significantly lower in infants weighing ≤10 kg (5.0 Gym2 versus 7.7 Gym2; P = .01). Patients weighing ≤10 kg had a greater frequency of complete tumor regression (82.6% versus 60.9%; P = .02). Mean fluoroscopy time was not significantly different (7.5 versus 7.2; P = .71). There was a significant difference in the frequency of enucleation (16 [21.6%] versus 52 [39.1%]; P = .01). Patients weighing ≤10 kg had greater number of aborted procedures (12 [5.4%] versus 7 [1.6%]; P = .01). On multivariate analysis, weight ≤10 kg was not an independent predictor of complications or procedure failure.CONCLUSIONS: Intra-arterial chemotherapy in patients weighing ≤10 kg is a safe and effective treatment.IACintra-arterial chemotherapyICRBInternational Classification of RetinoblastomaOAophthalmic arteryRbretinoblastoma