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Intraarterial chemotherapy for kissing macula tumors in retinoblastoma
David H Abramson1, Brian P Marr, Scott Brodie
1*Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York †Department of Ophthalmology, Mt. Sinai School of Medicine, New York, New York ‡Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York §Division of Interventional Neuroradiology, Department of Radiation, Neurosurgery and Neurology, Weill Cornell Medical College, New York, New York.
Purpose:
To describe the management of kissing macula retinoblastoma tumors treated with intraarterial chemotherapy.
Methods:
Superselective infusion of chemotherapy (combinations of melphalan, topotecan, and carboplatin) into the ophthalmic artery of children with retinoblastoma who had kissing macula tumors was administered on an outpatient basis. Results were assessed with indirect ophthalmoscopy, RetCam digital photography, B-scan ultrasonography, and electroretinograms. Three children with bilateral retinoblastoma (aged 6.1, 7, and 16 months) and kissing macula tumors in an eye were treated.
Results:
All children are alive without the need for removal of the eye, systemic chemotherapy, or external beam irradiation. In each case, the kissing tumors retracted, leaving an anatomically normal fovea. Final 30-Hz flicker electroretinograms were 93.9, 65, and 63.9 μV (under anesthesia). There were no significant systemic toxicities.
Conclusion:
Superselective infusion of chemotherapy by means of the ophthalmic artery of young children with kissing macula tumors resulted in prompt shrinkage of tumors away from the fovea. There were no systemic side effects.
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