Related Experiment Video
Updated: Dec 17, 2025
Ocular Therapeutic Delivery and Advanced Tissue Retrieval in Adult Rats
Published on: May 23, 2025
Intra-Arterial Chemotherapy for Retinoblastoma in Infants ≤10 kg: 74 Treated Eyes with 222 IAC Sessions
A Sweid1, B Hammoud2, J H Weinberg1
1From the Department of Neurosurgery (A.S., J.H.W., V.X., K.S., M.P.B., S.D., S.R., S.T., P.J.), Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania.
Insights
Intra-arterial chemotherapy is safe and effective for retinoblastoma in infants weighing 10 kg or less. This treatment offers a high success rate with comparable safety to older children.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Medical Imaging
Background:
- Intra-arterial chemotherapy (IAC) has transformed retinoblastoma treatment.
- High safety and efficacy enable treatment for lower-weight infants.
- Evaluating IAC in infants ≤10 kg is crucial for expanding treatment options.
Purpose of the Study:
- To assess the efficacy and safety of IAC infusions in infants weighing ≤10 kg with intraocular retinoblastoma.
- To compare outcomes between infants weighing ≤10 kg and those weighing >10 kg.
Main Methods:
- Retrospective chart review of retinoblastoma patients treated with IAC.
- Cohort divided into two groups: ≤10 kg and >10 kg.
- Analysis of periprocedural complications, tumor regression, radiation exposure, and enucleation rates.
Main Results:
- No significant difference in periprocedural complications between weight groups (0.9% vs 0.5%).
- Infants ≤10 kg showed significantly lower radiation exposure (5.0 vs 7.7 Gym²; P=.01) and higher complete tumor regression (82.6% vs 60.9%; P=.02).
- Lower enucleation rates in the ≤10 kg group (21.6% vs 39.1%; P=.01), despite a higher rate of aborted procedures (5.4% vs 1.6%; P=.01).
Conclusions:
- Intra-arterial chemotherapy is a safe and effective treatment for retinoblastoma in infants weighing ≤10 kg.
- IAC offers favorable outcomes, including reduced radiation exposure and enucleation rates, in this population.
- Weight ≤10 kg was not an independent predictor of complications or treatment failure.
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.
