Intra-arterial chemotherapy for unilateral advanced intraocular retinoblastoma: A long-term review of a case series.

Background: The role of intra-arterial chemotherapy (IAC) for globe salvage treatment of retinoblastoma (RB) has been validated clinically; however, data on its long-term effects remain limited. This study examined the long-term stable salvage rate of IAC in treating RB and assessed its potential adverse effects.

Methods: Patients diagnosed with unilateral advanced intraocular RB who achieved short-term globe salvage and began IAC treatment at our hospital between December 2016 and September 2019 were selected for this study. The collected clinical data included patient demographics, tumor stage, prior treatment history, course of IAC therapy, complications, combination therapy modalities outside of IAC, and long-term follow-up outcomes.

Results: Thirty-nine patients were included with a mean age at initial IAC treatment of 1.84 ± 1.18 years. Tumors were located in the right and left eyes of 22 and 17 patients, respectively. Based on the International Intraocular Retinoblastoma Classification (IIRC) grouping, Group D comprised 61.54%, whereas Group E accounted for 38.46% of the cases. The patients received 122 IAC sessions, with a median of three per patient. Follow-up data revealed a 5-year stable globe salvage rate of 87.18% with no treatment-related complications in 15 cases. The primary long-term adverse effects included cataracts, ocular growth arrest, and choroidal retinal atrophy/optic nerve atrophy.

Conclusions: IAC demonstrated excellent long-term therapeutic efficacy and safety for children with unilateral advanced intraocular RB.