Klin Monbl Augenheilkd 2021; 238(07): 788-796
DOI: 10.1055/a-1508-6194
Klinische Studie

Intraarterial Chemotherapy for Retinoblastoma – Initial Experiences of a German Reference Centre

Article in several languages: English | deutsch
Tobias Kiefer
1   Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
Sabrina Schlüter
1   Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
Nikolaos E. Bechrakis
1   Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
Norbert Bornfeld
1   Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
Sophia Göricke
2   Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Deutschland
Petra Ketteler
3   Klinik für pädiatrische Hämatologie und Onkologie, Universitätsklinikum Essen, Deutschland
Saskia Ting
4   Institut für Pathologie und Neuropathologie, Universitätsklinikum Essen, Deutschland
5   Westdeutsches Protonenzentrum Essen (WPE), Klinik für Partikeltherapie, Universitätsklinikum Essen, Deutschland
Eva Biewald
1   Klinik für Augenheilkunde, Universitätsklinikum Essen, Deutschland
› Author Affiliations


Background Adequate management of retinoblastoma requires a multidisciplinary and individual approach to treatment. Intraarterial chemotherapy (IAC) is one of the most commonly used treatment modalities, and enables supraselective application of chemotherapy via the ophthalmic artery and is now established in almost all treatment centres. However, published treatment success rates are heterogeneous. There are some unanswered issues regarding sight-threatening ocular complications and the long-term occurrence of secondary malignancies and metastatic disease. The objective of the present study is to analyse the results of a German national reference centre.

Methods Retrospective analysis of all children with an indication for at least one IAC from April 2010 to April 2020. IAC was used either as primary or recurrence therapy. Obligatory follow-up was at least 6 months.

Results 137 eyes of 127 children with an indication for IAC could be included. 12 eyes with a follow-up of less than 6 months and 37 eyes in which IAC was technically not feasible were excluded. In summary, 88 eyes of 79 children were finally analysed. Mean follow-up was 38 months, ranging from 7 to 117 months. In total, 195 procedures were completed. In 30 eyes (34.1%) IAC was conducted as primary and in 58 (65.9%) as secondary therapy. There was an initial IAC treatment response in 75 eyes (85.2%) with a recurrence-free rate of 61.3%. Eye salvage rate was 68.1% with 28 enucleated eyes in total. Ocular complications were observed in 36 eyes (40.9%), with 19 eyes (21.6%) showing severe sight-threatening and 11 eyes (12.5%) presenting minor non-sight-threatening toxic reactions. During follow-up, 1 child developed a secondary malignancy, 1 child developed metastasis and 1 child died as a consequence of trilateral retinoblastoma.

Conclusion In summary, IAC is a potent modality for retinoblastoma treatment and has been very successful, even in advanced disease and heavily pretreated eyes. However, ocular complications should be taken in consideration, especially when the only seeing eye is treated. Long term incidences of secondary malignancies and metastatic diseases should be further investigated in prospective studies.

Publication History

Received: 15 February 2021

Accepted: 11 May 2021

Article published online:
10 August 2021

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