Effectiveness of intravitreal chemotherapy-assisted endoresection in monocular patients with group D retinoblastoma

• Main Authors: Xiling Yu, Xueke Li, Yue Xing, Siduo Lu, Silvia Tanumiharjo, Jin Ma
• Format: Article
• Language: English
• Published: BMC 2020-08-01
• Series: BMC Cancer
• Subjects: Refractory retinoblastoma; Intravitreal chemotherapy; Endoresection; Pars plana vitrectomy
• Online Access: http://link.springer.com/article/10.1186/s12885-020-07314-1

Abstract Background This study aimed to determine the efficacy and complications of intravitreal chemotherapy-assisted endoresection for refractory International Classification of Retinoblastoma (ICRB) group D retinoblastoma in monocular patients. Methods In this retrospective case series, intravitreal chemotherapy-assisted endoresection by pars plana vitrectomy was performed in 11 eyes with refractory ICRB group D retinoblastoma unresponsive to standard therapies in monocular patients. Results Across a mean follow-up period of 42.7 months, globe salvage was attained in all 11 eyes (100%). There were no cases of extra-ocular tumour seeding or remote metastasis. In 9 eyes (81.8%), tumour control was achieved with one pars plana vitrectomy; in 2 cases (18.2%), repeated treatment, such as laser therapy, intravitreal chemotherapy or a second pars plana vitrectomy, was needed. Retinal reattachment was achieved in all 4 eyes (100%) with previous retinal detachment. Four eyes (36.4%) required subsequent cataract surgery due to secondary cataract. Ten eyes (90.9%) had improvement in best-corrected visual acuity at the last follow-up. Conclusion Intravitreal chemotherapy-assisted endoresection appears to be a safe and effective globe-salvaging method for refractory group D retinoblastoma. It is a promising alternative to enucleation and a supplementary therapeutic strategy for those unresponsive to standard therapies, especially for the monocular retinoblastoma patients.