The role for intra-arterial chemotherapy for refractory retinoblastoma: a systematic review

Runnels, Juliana; Acosta, Gabriella; Rose, Alexander; Haynes, Mark K.; Nikolaidis, Daniel; Wong, Amelia

doi:10.1007/s12094-021-02610-z

Cited by 8 publications

(11 citation statements)

References 63 publications

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“…The overall globe salvage rate was 79.6% for patients treated with IAC as primary therapy and 66.4% for patients treated with IAC as secondary therapy. These results were similar to a newly published systemic review performed by Runnels et al [ 8 ], which included 24 studies. The globe salvage rate was lower than that reported by Ravindran et al [ 9 ], which included 20 studies.…”

Section: Discussionsupporting

confidence: 91%

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The Safety and Effectiveness of Melphalan-Based Intra-Arterial Chemotherapy for Retinoblastoma: An Updated Single-Arm Systematic Review and Meta-Analysis

Cao

Zhou

Tian

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Melphalan-based intra-arterial chemotherapy was considered an innovative treatment for retinoblastoma patients because high rates of globe salvage could be obtained. Now it has been widely applied for primary or secondary treatment of retinoblastoma. This meta-analysis summarizes the most up-to-date evidence regarding the safety and effectiveness of melphalan-based intra-arterial chemotherapy in the treatment of retinoblastoma. The authors searched PubMed, EMBASE, and the Web of Science electronic databases for studies investigating the safety and effectiveness of melphalan-based intra-arterial chemotherapy in the treatment of retinoblastoma. Studies reporting outcomes and complications of melphalan-based intra-arterial chemotherapy for the treatment of retinoblastoma patients would be included. A total of 33 observational studies that involved 1900 patients and 2336 eyes were included. The overall globe salvage rate was 79.6% (773/971 eyes, 0.74 [95% CI: 0.66, 0.80]) for patients treated with IAC as primary therapy in 28 studies. The overall globe salvage rate was 66.4% (923/1391 eyes, 0.68 [95% CI: 0.60, 0.76]) for patients treated with IAC as secondary therapy in 25 studies. The most common ocular complications were retinopathy (32%) and palpebral edema (29.7%). The most common systemic complications were nausea/vomiting (20.9%). The overall metastasis rate was 1.1% (21/1793 patients, 0.038 [95% CI: 0.020, 0.038]). Twenty-nine studies that involved 1783 patients reported the mortality and the overall mortality was 1.5% (26/1783 patients, 0.029 [95% CI: 0.020, 0.048]). Our meta-analysis showed that melphalan-based IAC treatment was an option for retinoblastoma patients with acceptable efficacy according to retrospective studies. Further high-quality randomized control trials are necessary to provide more accurate and reliable results.

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Section: Discussionsupporting

confidence: 91%

“…Some previous systematic reviews have provided an extensive assessment of the evidence for IAC use in retinoblastoma [ 8 , 9 ]. Since these studies, there have been several further studies published.…”

Section: Introductionmentioning

confidence: 99%

The Safety and Effectiveness of Melphalan-Based Intra-Arterial Chemotherapy for Retinoblastoma: An Updated Single-Arm Systematic Review and Meta-Analysis

Cao

Zhou

Tian

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Additionally, the results showed no significant difference in vomiting among the observation, ondansetron, and metoclopramide groups, which might be related to the small sample size (n=12) of the observation group. Meanwhile, 19.3% (155/803) of the patients in this study had vomiting, which was lower than 20.5% reported in the literature (23). This difference suggests that there might be some uniqueness in the physique or treatment of children with RB, and might come from the fact that we only investigated CIV, rather than chemotherapyinduced nausea.…”

Section: Discussioncontrasting

confidence: 73%

Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study

Zeng¹,

Chen²,

Xu³

et al. 2021

Transl Pediatr

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Background: The chemotherapy-induced vomiting (CIV) severely affects the daily function, nutritional status, treatment compliance, therapeutic efficacy, curability, and the quality of life of patients. The aim of this study was to find the risk factors for CIV after general anesthesia in patients with retinoblastoma (RB).Methods: A retrospective review of the hospital records of children with RB, who underwent chemotherapy between January 2017 and December 2019, was conducted at our hospital.Results: Data of a total of 803 children with RB were reviewed. The incidence of CIV in children with RB was 19.30%. Univariate analysis showed statistically significant differences in age, height, weight, chemotherapy regimen, anesthesia dose, duration of surgery and general anesthesia, platelet count, platelet distribution width, lymphocytes, and indirect bilirubin between patients with and without vomiting (P<0.05).Multivariate logistic regression analysis showed that the main predictors of CIV in children with RB included older age [odds ratio (OR), 1.32; 95% confidence interval (CI): 1.11-1.56; P<0.01], low platelet count (OR, 0.997; 95% CI: 0.995-0.999; P<0.05), and chemotherapy regimen (intravenous chemotherapy versus intraarterial chemotherapy; OR, 0.47; 95% CI: 0.29-0.76; P<0.01).Conclusions: This study revealed age, chemotherapy regimen, and platelet count as risk factors of CIV after general anesthesia in children with RB. Younger age and higher platelet count were protective factors for CIV. Compared with intravenous chemotherapy, the incidence of CIV was lower than that of intraarterial chemotherapy. Although these factors cannot be modified, they can predict whether a patient may experience vomiting, assisting medical staff to formulate measures and intervenes in advance.

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“…Furthermore, the possibility to perform a chemo-filtration ensures lowest systemic toxicity effects. RegCTx efficacy has been proven in many cancers but has not been reported in GC series [11,12,14,15,[17][18][19][20]. Here we report on our institutional experience with 38 far advanced metastatic GC patients undergoing RegCTx after failure to sCTx.…”

Section: Introductionmentioning

confidence: 98%

“…Regional chemotherapy (RegCTx) is an oncological approach with very low toxicity profile and high tumour response due to high cytotoxic drug concentration in the isolated perfusion bed [11][12][13][14][15][16][17][18][19]. In addition, the therapy can be focused on limited regions if necessary, using the same technique e.g., hypoxic abdominal stop-flow perfusion (HAP), upper abdominal perfusion (UAP), isolated thoracic perfusion (ITP) and hypoxic pelvic perfusions (HPP) as well as intra-arterial infusion.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Regional Chemotherapy Approach in Peritoneal Metastatic Gastric Cancer

Aigner

Vashist

Selak

et al. 2021

JCM

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Peritoneal spread is frequent in gastric cancer (GC) and a palliative condition. After failure to systemic chemotherapy (sCTx) remaining therapeutic options are very limited. We evaluated the feasibility and efficacy of locoregional chemotherapy (RegCTx) in peritoneal metastatic GC. In total, 38 (23 male and 15 female) patients with peritoneal metastatic GC after failure of previous sCTx and unresectable disease were enrolled in this study. Using the hypoxic abdominal stop-flow perfusion, upper abdominal perfusion and intraarterial infusion technique in total 114 cycles with Cisplatin, Adriamycin and Mitomycin C were applied. No significant procedure related toxicity was noticed- especially no Grade 3 or 4 toxicity occurred. With the RegCTx approach a median overall survival of 17.4 months was achieved. Patients who had undergone previously resection of the GC the median overall survival was even better with 23.5 months. RegCTx is a promising, safe and efficient approach in diffuse metastatic GC. The evaluation of RegCTx in the setting of multimodal treatment approach at less advanced stages is also warranted.

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The role for intra-arterial chemotherapy for refractory retinoblastoma: a systematic review

Cited by 8 publications

References 63 publications

The Safety and Effectiveness of Melphalan-Based Intra-Arterial Chemotherapy for Retinoblastoma: An Updated Single-Arm Systematic Review and Meta-Analysis

The Safety and Effectiveness of Melphalan-Based Intra-Arterial Chemotherapy for Retinoblastoma: An Updated Single-Arm Systematic Review and Meta-Analysis

Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study

Efficacy of Regional Chemotherapy Approach in Peritoneal Metastatic Gastric Cancer

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