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Outcome of salvage intra-arterial chemotherapy for recurrent retinoblastoma

Abstract

Purpose

To examine the outcome of salvage intra-arterial chemotherapy (IAC) for patients with recurrent retinoblastoma after the initial course of IAC and determine the factors influencing clinical outcome.

Methods

A total of 73 eyes of 71 patients with recurrent retinoblastoma undergoing salvage IAC after initial successfully IAC between May 2014 and May 2019 were retrospectively reviewed for clinical outcomes. Ocular survival and progression-free survival were used to examine the efficacy of salvage IAC. The factors influencing clinical outcomes were determined using univariate and multivariate analyses.

Results

The salvage IAC was delivered at mean 9.4 months (median 7, range 2.1–38.3 months) following the last cycle of initial IAC. 86.5% (64/73) eyes relapsed 16 months after the initial IAC. After the salvage IAC, 57 eyes (78.1%) were salvaged, and no further-line therapies were required for 36 eyes (49.3%). The 2-year Kaplan–Meier ocular survival and progression-free survival estimates after salvage IAC were 66.4% (95% CI, 31.5–42.1%) and 38.2% (95% CI, 17.8–28.8%), respectively. Univariate and multivariate analyses showed that the ocular survival and progression-free survival after salvage IAC were significantly associated with the history of vitreous seeds (p = 0.02 and p = 0.03, respectively).

Conclusion

Salvage IAC is effective for the management of recurrent retinoblastoma after the initial successful IAC. Eyes with a history of vitreous seeds in the course of the disease are more likely to relapse and with worse ocular survival. A close follow-up strategy is imperative to treat the recurrent tumour after salvage IAC.

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Fig. 1: Recurrent tumor control was achieved by salvage IAC.
Fig. 2: Survival analysis of patients in our cohort.

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Acknowledgements

This study was funded by grants from the National Natural Science Foundation of China (81770964 to PZ and 81873679 to JL).

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Contributions

JL was responsible for designing the review protocol, writing the protocol and article, conducting the search, extracting and analysing data, interpreting results, updating reference lists; CJ was responsible for the operation of intra-arterial chemotherapy, extracting and analysing data; XH was responsible for the operation of intra-arterial chemotherapy and provide clinical data; TL was responsible for the collection and sorting of information; JL was responsible for designing the review protocol and screening potentially eligible studies; PZ contributed to the design of the review protocol and provided feedback on the report; XJ was responsible for the provision of clinical data and designing the review protocol.

Corresponding authors

Correspondence to Peiquan Zhao or Xunda Ji.

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The authors declare no competing interests.

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Li, J., Jing, C., Hua, X. et al. Outcome of salvage intra-arterial chemotherapy for recurrent retinoblastoma. Eye (2021). https://doi.org/10.1038/s41433-021-01693-w

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