Periocular topotecan for vitreous seeds in retinoblastoma

Purpose: Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma. Methods: Retrospective, interventiona...

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Main Authors: Purnima R Sthapit, Raksha Rao, Santosh G Honavar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=12;spage=1833;epage=1838;aulast=Sthapit
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spelling doaj-7e027dc2d22a48c3814a6606d6ee2c782020-11-25T02:43:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892018-01-0166121833183810.4103/ijo.IJO_737_18Periocular topotecan for vitreous seeds in retinoblastomaPurnima R SthapitRaksha RaoSantosh G HonavarPurpose: Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma. Methods: Retrospective, interventional study of patients with retinoblastoma with vitreous seeds who received POT concurrent with intravenous chemotherapy (IVC). Results: Thirty-eight eyes of 35 patients received POT. Five eyes (13%) belonged to International Classification of Retinoblastoma group C, 23 eyes (61%) belonged to group D, and 10 eyes (26%) belonged to group E. Primary treatment included IVC with a combination of carboplatin, etoposide, and vincristine for a mean of 6 cycles (median 6; range 6–9). Concurrent to IVC from the fourth cycle onward, all patients received POT. Focal vitreous seeds were present in 20 eyes (53%) which received a mean of 3 injections (median 3; range 1–7). Diffuse vitreous seeds were present in 18 eyes (47%) which received a mean of 4 injections (median 5; range 1–7). At a mean follow-up of 8.5 months (median 5 months; range 1–15 months), regression of focal and diffuse vitreous seeds was achieved in 16 eyes (80%) and 8 eyes (44%), respectively. In all, 24 eyes (63%) had complete remission of vitreous seeds with POT given concurrently with IVC. Eye salvage was possible in 19 eyes (95%) with focal vitreous seeds and 12 eyes (68%) with diffuse VS. Enucleation was necessary for persistent vitreous seeds and viable tumor in five eyes (13%), viable tumor alone in one eye (0.02%), and recurrent vitreous seeds in one eye (0.02%). None of the patients developed systemic metastasis. Conclusion: POT administered concurrent with IVC is safe and effective in the initial management of vitreous seeds.http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=12;spage=1833;epage=1838;aulast=SthapitPeriocular injectionretinoblastomatopotecanvitreous seeds
collection DOAJ
language English
format Article
sources DOAJ
author Purnima R Sthapit
Raksha Rao
Santosh G Honavar
spellingShingle Purnima R Sthapit
Raksha Rao
Santosh G Honavar
Periocular topotecan for vitreous seeds in retinoblastoma
Indian Journal of Ophthalmology
Periocular injection
retinoblastoma
topotecan
vitreous seeds
author_facet Purnima R Sthapit
Raksha Rao
Santosh G Honavar
author_sort Purnima R Sthapit
title Periocular topotecan for vitreous seeds in retinoblastoma
title_short Periocular topotecan for vitreous seeds in retinoblastoma
title_full Periocular topotecan for vitreous seeds in retinoblastoma
title_fullStr Periocular topotecan for vitreous seeds in retinoblastoma
title_full_unstemmed Periocular topotecan for vitreous seeds in retinoblastoma
title_sort periocular topotecan for vitreous seeds in retinoblastoma
publisher Wolters Kluwer Medknow Publications
series Indian Journal of Ophthalmology
issn 0301-4738
1998-3689
publishDate 2018-01-01
description Purpose: Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma. Methods: Retrospective, interventional study of patients with retinoblastoma with vitreous seeds who received POT concurrent with intravenous chemotherapy (IVC). Results: Thirty-eight eyes of 35 patients received POT. Five eyes (13%) belonged to International Classification of Retinoblastoma group C, 23 eyes (61%) belonged to group D, and 10 eyes (26%) belonged to group E. Primary treatment included IVC with a combination of carboplatin, etoposide, and vincristine for a mean of 6 cycles (median 6; range 6–9). Concurrent to IVC from the fourth cycle onward, all patients received POT. Focal vitreous seeds were present in 20 eyes (53%) which received a mean of 3 injections (median 3; range 1–7). Diffuse vitreous seeds were present in 18 eyes (47%) which received a mean of 4 injections (median 5; range 1–7). At a mean follow-up of 8.5 months (median 5 months; range 1–15 months), regression of focal and diffuse vitreous seeds was achieved in 16 eyes (80%) and 8 eyes (44%), respectively. In all, 24 eyes (63%) had complete remission of vitreous seeds with POT given concurrently with IVC. Eye salvage was possible in 19 eyes (95%) with focal vitreous seeds and 12 eyes (68%) with diffuse VS. Enucleation was necessary for persistent vitreous seeds and viable tumor in five eyes (13%), viable tumor alone in one eye (0.02%), and recurrent vitreous seeds in one eye (0.02%). None of the patients developed systemic metastasis. Conclusion: POT administered concurrent with IVC is safe and effective in the initial management of vitreous seeds.
topic Periocular injection
retinoblastoma
topotecan
vitreous seeds
url http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=12;spage=1833;epage=1838;aulast=Sthapit
work_keys_str_mv AT purnimarsthapit perioculartopotecanforvitreousseedsinretinoblastoma
AT raksharao perioculartopotecanforvitreousseedsinretinoblastoma
AT santoshghonavar perioculartopotecanforvitreousseedsinretinoblastoma
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