Clinical Science
Comparison of clinical outcomes of ophthalmic artery chemotherapy with systemic vein-eye artery chemotherapy for retinoblastoma in children
Di Qi, Shen Gang, Shi Shengli, Lu Yuebing, Zhang Jing, Liu Jing, Hu Jing, Chen Zhiping
Published 2022-11-10
Cite as Chin J Exp Ophthalmol, 2022, 40(11): 1071-1077. DOI: 10.3760/cma.j.cn115989-20200917-00652
Abstract
ObjectiveTo compare the clinical efficacy, prognosis and complications between intravenous chemotherapy (IVC) combined with intra-arterial chemotherapy (IAC) and single IAC in the treatment of children retinoblastoma (RB).
MethodsA cohort study was performed.A 4-year follow-up of 300 children (352 eyes) with intraocular RB enrolled in the Children's Hospital Affiliated of Zhengzhou University from June 2015 to June 2019 was conducted.According to the different treatment methods, the children were divided into IAC group (140 cases, 160 eyes) treated with IAC combined with local laser photocoagulation/cryotherapy and IVC+ IAC group (160 cases, 192 eyes) receiving IVC combined with IAC treatment.The clinical efficacy (eye salvage rate), survival and complication incidence of the two groups were compared.The survival analysis was performed by Kaplan-Meier method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Children's Hospital Affiliated of Zhengzhou University (No.20150503). Written informed consent was obtained from custodians of each child prior to their entering into the cohort.
ResultsAll of the children were followed up for 2-60 months.Within the follow-up, the eye retention rate of the IAC group and IVC+ IAC group was 85.62%(137/160) and 81.21%(154/192) respectively, without statistically significant difference (P>0.05). The recurrence rate and metastasis rate of IAC group were 18.75%(30/160) and 8.57%(12/140), which were significantly higher than 10.94%(21/192) and 3.13%(5/160) of IVC+ IAC group (χ2=4.299, P=0.038; χ2=4.143, P=0.042). There was no significant difference in one-year survival rate between the two groups (χ2=1.766, P=0.184), but the overall survival rate of IVC+ IAC group was 95.00%(152/160), significantly higher than 88.57%(124/140) of IAC group (χ2=4.193, P=0.041). Kaplan-Meier analysis showed that the overall recurrence-free, metastasis-free and survival rate of IVC+ IAC group were better than those of IAC group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the incidence of eyelid edema and/or ptosis, fundus hemorrhage, enophthalmos and cataract between the two groups (all at P>0.05). The incidence of myelosuppression was 32.14%(45/140) in IAC group, significantly lower than 43.75%(70/160) of IVC+ IAC group (χ2=4.255, P=0.039).
ConclusionsCompared with single IAC treatment, IVC combined with IAC can reduce the metastasis rate, recurrence rate in RB child patient and improve the survival rate, but it is with relatively high incidence of systemic complications.
Key words:
Retinoblastoma; Chemotherapy; Ophthalmic artery perfusion; Survival rate; Recurrence rate; Complications
Contributor Information
Di Qi
Department of Radiology, Chidren's Hospital Affiliated of Zhengzhou University, Henan Children's Hospital, Zhengzhou 450018, China
Di Qi is now working at the Interventional Hemangioma Department, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, China
Shen Gang
Interventional Hemangioma Department, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, China
Shi Shengli
Department of Radiology, Chidren's Hospital Affiliated of Zhengzhou University, Henan Children's Hospital, Zhengzhou 450018, China
Lu Yuebing
Department of Radiology, Chidren's Hospital Affiliated of Zhengzhou University, Henan Children's Hospital, Zhengzhou 450018, China
Zhang Jing
Department of Hemangioma Intervention, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
Liu Jing
Department of Radiology, Chidren's Hospital Affiliated of Zhengzhou University, Henan Children's Hospital, Zhengzhou 450018, China
Hu Jing
Department of Radiology, Chidren's Hospital Affiliated of Zhengzhou University, Henan Children's Hospital, Zhengzhou 450018, China
Chen Zhiping
Department of Radiology, Chidren's Hospital Affiliated of Zhengzhou University, Henan Children's Hospital, Zhengzhou 450018, China
