Ocular survival after intra‐arterial chemotherapy for retinoblastoma improves with accrual of experience and programmatic evolution
Background Intra‐arterial chemotherapy (IAC) for the treatment of intraocular retinoblastoma has gained recognition as a method to improve ocular salvage; however, there is a paucity of evidence supporting treatment factors prognosticating ocular survival. Methods All patients with retinoblastoma tr...
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| Veröffentlicht in: | Pediatric blood & cancer 2023-02, Vol.70 (2), p.e30071-n/a |
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| creator | Marasligiller, Stefan A. Williams, Basil K. Vadivelu, Sudhakar Correa, Zelia M. Abruzzo, Todd A. Nicola, Maura Di Lane, Adam Geller, James I. |
| description | Background
Intra‐arterial chemotherapy (IAC) for the treatment of intraocular retinoblastoma has gained recognition as a method to improve ocular salvage; however, there is a paucity of evidence supporting treatment factors prognosticating ocular survival.
Methods
All patients with retinoblastoma treated with IAC at a single institution between December 2008 and December 2019 were evaluated. Patient demographics, tumor classification, prior treatments, procedural data, other non‐IAC therapies, adverse reactions, procedural complications, ocular outcomes, and overall survival were assessed via retrospective chart review. Factors suggestive of increased ocular survival were identified via univariate and multivariate analyses. The impact of accrued treatment experience was evaluated by grouping eyes by the respective year, IAC treatment was initiated.
Results
Forty‐nine eyes of 43 patients were treated for retinoblastoma with IAC (256 total procedures). At least grade 3 neutropenia was observed following 19% of IAC procedures. The risk of neutropenia was not statistically different between single or multidrug IAC. Comparing those who received balloon‐assisted intra‐arterial chemotherapy (bIAC) in more than two‐thirds of cycles to those who did not, the risk of arterial access site complications was not statistically different. Multivariate analysis revealed a significantly lower risk of enucleation associated with treatment era in years (hazard ratio [HR] = 0.52–1.00, p |
| doi_str_mv | 10.1002/pbc.30071 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9790034</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2757254528</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4081-76152d9e5039415bf234facba07af81cb2edc9cfab5a6e68d66ba11ba8aaf6633</originalsourceid><addsrcrecordid>eNp1kctu1DAUhi0EoqWw4AWQJTawmNaOYyfZIMGIm1SpLGBtnXiOO66cONhOyuzYsOcZeRJcpowAiZVvn79zjn5CHnN2yhmrzqbenArGGn6HHHNZy5VkvLl72LPuiDxI6aqgisn2PjkSStSdrPgx-XZhZg-RpjkubgFPwWaM1I05wo-v3yGWkyvXZotDyFuMMO2oDZFGzG4MvYeUwwDUDVMMCyZ67fKWgjFxLr-CpfhlKgYcDVIYN7RQlxGGAbIzFJfg5-zC-JDcs-ATPrpdT8inN68_rt-tzi_evl-_PF-ZmrV81Sguq02Hkomu5rK3lagtmB5YA7blpq9wYzpjoZegULUbpXrgvIcWwColxAl5sfdOcz8UFm_G9HqKboC40wGc_vtldFt9GRbdNR1joi6CZ7eCGD7PmLIeXDLoPYwY5qSrRtSKl1K8oE__Qa_CHMcyXqFkU5VsqrZQz_eUiSGliPbQDGf6JlxdwtW_wi3skz-7P5C_0yzA2R64dh53_zfpD6_We-VPVd-0TA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2757254528</pqid></control><display><type>article</type><title>Ocular survival after intra‐arterial chemotherapy for retinoblastoma improves with accrual of experience and programmatic evolution</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Marasligiller, Stefan A. ; Williams, Basil K. ; Vadivelu, Sudhakar ; Correa, Zelia M. ; Abruzzo, Todd A. ; Nicola, Maura Di ; Lane, Adam ; Geller, James I.</creator><creatorcontrib>Marasligiller, Stefan A. ; Williams, Basil K. ; Vadivelu, Sudhakar ; Correa, Zelia M. ; Abruzzo, Todd A. ; Nicola, Maura Di ; Lane, Adam ; Geller, James I.</creatorcontrib><description>Background
Intra‐arterial chemotherapy (IAC) for the treatment of intraocular retinoblastoma has gained recognition as a method to improve ocular salvage; however, there is a paucity of evidence supporting treatment factors prognosticating ocular survival.
Methods
All patients with retinoblastoma treated with IAC at a single institution between December 2008 and December 2019 were evaluated. Patient demographics, tumor classification, prior treatments, procedural data, other non‐IAC therapies, adverse reactions, procedural complications, ocular outcomes, and overall survival were assessed via retrospective chart review. Factors suggestive of increased ocular survival were identified via univariate and multivariate analyses. The impact of accrued treatment experience was evaluated by grouping eyes by the respective year, IAC treatment was initiated.
Results
Forty‐nine eyes of 43 patients were treated for retinoblastoma with IAC (256 total procedures). At least grade 3 neutropenia was observed following 19% of IAC procedures. The risk of neutropenia was not statistically different between single or multidrug IAC. Comparing those who received balloon‐assisted intra‐arterial chemotherapy (bIAC) in more than two‐thirds of cycles to those who did not, the risk of arterial access site complications was not statistically different. Multivariate analysis revealed a significantly lower risk of enucleation associated with treatment era in years (hazard ratio [HR] = 0.52–1.00, p < .05) and laser therapies (HR = 0.02–0.60, p < .05).
Conclusions
Ocular survival rates in patients treated with IAC for retinoblastoma at our institution have increased over time. Accrued treatment experience and programmatic changes have likely contributed. Larger, prospective series may lead to a better understanding of factors that consistently contribute to better ocular salvage.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.30071</identifier><identifier>PMID: 36349521</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Balloon treatment ; Chemotherapy ; Enucleation ; Hematology ; Humans ; Infant ; Infusions, Intra-Arterial ; intravitreal chemotherapy ; intra‐arterial chemotherapy ; laser photocoagulation ; Melphalan ; Multivariate analysis ; Neutropenia ; Oncology ; Pediatrics ; Retinal Neoplasms - pathology ; Retinoblastoma ; Retinoblastoma - pathology ; Retrospective Studies ; Survival ; temporary balloon occlusion ; Treatment Outcome ; Tumors</subject><ispartof>Pediatric blood & cancer, 2023-02, Vol.70 (2), p.e30071-n/a</ispartof><rights>2022 Wiley Periodicals LLC.</rights><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4081-76152d9e5039415bf234facba07af81cb2edc9cfab5a6e68d66ba11ba8aaf6633</citedby><cites>FETCH-LOGICAL-c4081-76152d9e5039415bf234facba07af81cb2edc9cfab5a6e68d66ba11ba8aaf6633</cites><orcidid>0000-0001-5181-116X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.30071$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.30071$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,781,785,886,1418,27928,27929,45578,45579</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36349521$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marasligiller, Stefan A.</creatorcontrib><creatorcontrib>Williams, Basil K.</creatorcontrib><creatorcontrib>Vadivelu, Sudhakar</creatorcontrib><creatorcontrib>Correa, Zelia M.</creatorcontrib><creatorcontrib>Abruzzo, Todd A.</creatorcontrib><creatorcontrib>Nicola, Maura Di</creatorcontrib><creatorcontrib>Lane, Adam</creatorcontrib><creatorcontrib>Geller, James I.</creatorcontrib><title>Ocular survival after intra‐arterial chemotherapy for retinoblastoma improves with accrual of experience and programmatic evolution</title><title>Pediatric blood & cancer</title><addtitle>Pediatr Blood Cancer</addtitle><description>Background
Intra‐arterial chemotherapy (IAC) for the treatment of intraocular retinoblastoma has gained recognition as a method to improve ocular salvage; however, there is a paucity of evidence supporting treatment factors prognosticating ocular survival.
Methods
All patients with retinoblastoma treated with IAC at a single institution between December 2008 and December 2019 were evaluated. Patient demographics, tumor classification, prior treatments, procedural data, other non‐IAC therapies, adverse reactions, procedural complications, ocular outcomes, and overall survival were assessed via retrospective chart review. Factors suggestive of increased ocular survival were identified via univariate and multivariate analyses. The impact of accrued treatment experience was evaluated by grouping eyes by the respective year, IAC treatment was initiated.
Results
Forty‐nine eyes of 43 patients were treated for retinoblastoma with IAC (256 total procedures). At least grade 3 neutropenia was observed following 19% of IAC procedures. The risk of neutropenia was not statistically different between single or multidrug IAC. Comparing those who received balloon‐assisted intra‐arterial chemotherapy (bIAC) in more than two‐thirds of cycles to those who did not, the risk of arterial access site complications was not statistically different. Multivariate analysis revealed a significantly lower risk of enucleation associated with treatment era in years (hazard ratio [HR] = 0.52–1.00, p < .05) and laser therapies (HR = 0.02–0.60, p < .05).
Conclusions
Ocular survival rates in patients treated with IAC for retinoblastoma at our institution have increased over time. Accrued treatment experience and programmatic changes have likely contributed. Larger, prospective series may lead to a better understanding of factors that consistently contribute to better ocular salvage.</description><subject>Balloon treatment</subject><subject>Chemotherapy</subject><subject>Enucleation</subject><subject>Hematology</subject><subject>Humans</subject><subject>Infant</subject><subject>Infusions, Intra-Arterial</subject><subject>intravitreal chemotherapy</subject><subject>intra‐arterial chemotherapy</subject><subject>laser photocoagulation</subject><subject>Melphalan</subject><subject>Multivariate analysis</subject><subject>Neutropenia</subject><subject>Oncology</subject><subject>Pediatrics</subject><subject>Retinal Neoplasms - pathology</subject><subject>Retinoblastoma</subject><subject>Retinoblastoma - pathology</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>temporary balloon occlusion</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>1545-5009</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhi0EoqWw4AWQJTawmNaOYyfZIMGIm1SpLGBtnXiOO66cONhOyuzYsOcZeRJcpowAiZVvn79zjn5CHnN2yhmrzqbenArGGn6HHHNZy5VkvLl72LPuiDxI6aqgisn2PjkSStSdrPgx-XZhZg-RpjkubgFPwWaM1I05wo-v3yGWkyvXZotDyFuMMO2oDZFGzG4MvYeUwwDUDVMMCyZ67fKWgjFxLr-CpfhlKgYcDVIYN7RQlxGGAbIzFJfg5-zC-JDcs-ATPrpdT8inN68_rt-tzi_evl-_PF-ZmrV81Sguq02Hkomu5rK3lagtmB5YA7blpq9wYzpjoZegULUbpXrgvIcWwColxAl5sfdOcz8UFm_G9HqKboC40wGc_vtldFt9GRbdNR1joi6CZ7eCGD7PmLIeXDLoPYwY5qSrRtSKl1K8oE__Qa_CHMcyXqFkU5VsqrZQz_eUiSGliPbQDGf6JlxdwtW_wi3skz-7P5C_0yzA2R64dh53_zfpD6_We-VPVd-0TA</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Marasligiller, Stefan A.</creator><creator>Williams, Basil K.</creator><creator>Vadivelu, Sudhakar</creator><creator>Correa, Zelia M.</creator><creator>Abruzzo, Todd A.</creator><creator>Nicola, Maura Di</creator><creator>Lane, Adam</creator><creator>Geller, James I.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5181-116X</orcidid></search><sort><creationdate>202302</creationdate><title>Ocular survival after intra‐arterial chemotherapy for retinoblastoma improves with accrual of experience and programmatic evolution</title><author>Marasligiller, Stefan A. ; Williams, Basil K. ; Vadivelu, Sudhakar ; Correa, Zelia M. ; Abruzzo, Todd A. ; Nicola, Maura Di ; Lane, Adam ; Geller, James I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4081-76152d9e5039415bf234facba07af81cb2edc9cfab5a6e68d66ba11ba8aaf6633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Balloon treatment</topic><topic>Chemotherapy</topic><topic>Enucleation</topic><topic>Hematology</topic><topic>Humans</topic><topic>Infant</topic><topic>Infusions, Intra-Arterial</topic><topic>intravitreal chemotherapy</topic><topic>intra‐arterial chemotherapy</topic><topic>laser photocoagulation</topic><topic>Melphalan</topic><topic>Multivariate analysis</topic><topic>Neutropenia</topic><topic>Oncology</topic><topic>Pediatrics</topic><topic>Retinal Neoplasms - pathology</topic><topic>Retinoblastoma</topic><topic>Retinoblastoma - pathology</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>temporary balloon occlusion</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marasligiller, Stefan A.</creatorcontrib><creatorcontrib>Williams, Basil K.</creatorcontrib><creatorcontrib>Vadivelu, Sudhakar</creatorcontrib><creatorcontrib>Correa, Zelia M.</creatorcontrib><creatorcontrib>Abruzzo, Todd A.</creatorcontrib><creatorcontrib>Nicola, Maura Di</creatorcontrib><creatorcontrib>Lane, Adam</creatorcontrib><creatorcontrib>Geller, James I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric blood & cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marasligiller, Stefan A.</au><au>Williams, Basil K.</au><au>Vadivelu, Sudhakar</au><au>Correa, Zelia M.</au><au>Abruzzo, Todd A.</au><au>Nicola, Maura Di</au><au>Lane, Adam</au><au>Geller, James I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ocular survival after intra‐arterial chemotherapy for retinoblastoma improves with accrual of experience and programmatic evolution</atitle><jtitle>Pediatric blood & cancer</jtitle><addtitle>Pediatr Blood Cancer</addtitle><date>2023-02</date><risdate>2023</risdate><volume>70</volume><issue>2</issue><spage>e30071</spage><epage>n/a</epage><pages>e30071-n/a</pages><issn>1545-5009</issn><eissn>1545-5017</eissn><abstract>Background
Intra‐arterial chemotherapy (IAC) for the treatment of intraocular retinoblastoma has gained recognition as a method to improve ocular salvage; however, there is a paucity of evidence supporting treatment factors prognosticating ocular survival.
Methods
All patients with retinoblastoma treated with IAC at a single institution between December 2008 and December 2019 were evaluated. Patient demographics, tumor classification, prior treatments, procedural data, other non‐IAC therapies, adverse reactions, procedural complications, ocular outcomes, and overall survival were assessed via retrospective chart review. Factors suggestive of increased ocular survival were identified via univariate and multivariate analyses. The impact of accrued treatment experience was evaluated by grouping eyes by the respective year, IAC treatment was initiated.
Results
Forty‐nine eyes of 43 patients were treated for retinoblastoma with IAC (256 total procedures). At least grade 3 neutropenia was observed following 19% of IAC procedures. The risk of neutropenia was not statistically different between single or multidrug IAC. Comparing those who received balloon‐assisted intra‐arterial chemotherapy (bIAC) in more than two‐thirds of cycles to those who did not, the risk of arterial access site complications was not statistically different. Multivariate analysis revealed a significantly lower risk of enucleation associated with treatment era in years (hazard ratio [HR] = 0.52–1.00, p < .05) and laser therapies (HR = 0.02–0.60, p < .05).
Conclusions
Ocular survival rates in patients treated with IAC for retinoblastoma at our institution have increased over time. Accrued treatment experience and programmatic changes have likely contributed. Larger, prospective series may lead to a better understanding of factors that consistently contribute to better ocular salvage.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36349521</pmid><doi>10.1002/pbc.30071</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5181-116X</orcidid></addata></record> |
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| subjects | Balloon treatment Chemotherapy Enucleation Hematology Humans Infant Infusions, Intra-Arterial intravitreal chemotherapy intra‐arterial chemotherapy laser photocoagulation Melphalan Multivariate analysis Neutropenia Oncology Pediatrics Retinal Neoplasms - pathology Retinoblastoma Retinoblastoma - pathology Retrospective Studies Survival temporary balloon occlusion Treatment Outcome Tumors |
| title | Ocular survival after intra‐arterial chemotherapy for retinoblastoma improves with accrual of experience and programmatic evolution |
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