Severe ocular and orbital toxicity after intracarotid injection of carboplatin for recurrent glioblastomas

Watanabe, Wataru; Kuwabara, R; Nakahara, Toshinori; Hamasaki, Osamu; Sakamoto, Ikuo; Okada, Koji; Minamoto, Atsushi; Mishima, Hiromu K.

doi:10.1007/s00417-002-0573-9

Cited by 37 publications

(10 citation statements)

References 7 publications

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“…Selective IA administration of chemotherapeutics carries its own set of risks. Infra-ophthalmic carotid administration has been associated with CNS and retinal toxicity 14,15 , leukoencephalopathy 16 and deafness 17 . Headache, seizures, transient mental status changes, groin hematomas and urinary retention or incontinence have been reported 18 .…”

Section: Resultsmentioning

confidence: 99%

Vascular Distribution of Glioblastoma Multiforme at Diagnosis

Yohay¹,

Wolf²,

Aronson

et al. 2013

Interv Neuroradiol

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Treatment of high-grade gliomas with selective intra-arterial (IA) administration of chemotherapies has been proposed, and utilized as a therapeutic modality. This approach offers the conceptual benefit of providing maximal delivery of the agent to the tumor bed, while potentially reducing systemic exposure to the agent. This retrospective study was designed to determine the vascular distribution of glioblastoma multiforme (GBM) at the time of diagnosis in an effort to determine what proportion of patients would likely be candidates for this approach. The preoperative MRI scans of 50 patients with GBM were analyzed and compared to published normative data of intracranial vascular distribution. Vascular distribution was determined by analyzing post-gadolinium axial and coronal T1 images, axial T2 images, and axial T2 images with an additional 1 cm margin (T2 + 1 cm) added in all dimensions. T1 analysis demonstrated 60% of tumors in a single vascular distribution. T2 analysis of these tumors reduced that number to 34%. When the T2 + 1 cm margin was utilized, only 6% of tumors were in a single vascular distribution. 66% of tumors were limited to the anterior circulation on T1 imaging but only 34% on T2 + 1 cm imaging. 30% of tumors were also within the distribution of the anterior choroidal artery. These findings suggest that the use of selective IA administration of agents is necessarily limited to a fraction of presenting patients or will require administration via multiple cerebral arteries.

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Section: Resultsmentioning

confidence: 99%

Vascular Distribution of Glioblastoma Multiforme at Diagnosis

Yohay¹,

Wolf²,

Aronson

et al. 2013

Interv Neuroradiol

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“…Because local relapse occurred in 3 of 4 cases, we thought that administration of cisplatin via the internal maxillary artery only was insufficient to cover an entire tumor extending into the skull base plate. Administration into the optic artery may lead to visual disorders or central complications, such as brain infarction, and subsequently worsen the quality of life [9]. Therefore, we believe that RADPLAT should not be considered for LASCC-ES extending into the skull base plate or intracranial organs.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes of Locally Advanced Squamous Cell Carcinoma of the Ethmoid Sinus Treated with Anterior Craniofacial Resection or Chemoradiotherapy

et al. 2017

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We retrospectively analyzed 14 patients with locally advanced squamous cell carcinoma of ethmoid sinus (LASCC-ES) for the feasibility of anterior craniofacial resection (ACFR). Ethmoid cancer treatment comprised alternating chemoradiotherapy (ALCRT; n = 1), concomitant radiotherapy and intra-arterial cisplatin (RADPLAT; n = 4) and ACFR (n = 9). The 3- and 5-year overall survival (OS) rates of patients were 47.6 and 39.6%, respectively. The 3-year local control (LC) rates of chemoradiotherapy (CRT; ALCRT and RADPLAT) (n = 5) and ACFR (n = 9) groups were 0 and 66.7% (p = 0.012), respectively. The 3-year progression-free survival (PFS) rate of the CRT and ACFR groups were 0 and 55.6% (p = 0.018), respectively. The 3-year OS rate of the CRT and ACFR groups were 0 and 76.2% (p = 0.005), respectively. Postoperative pathological examinations confirmed positive margins in 3 (33%) of 9 cases. The 3-year LC and PFS rates of cases (n = 3) with positive surgical margins were significantly poorer than those of cases (n = 6) with negative surgical margins. Although ACFR for LASCC-ES is a feasible treatment, cases with positive surgical margins were more prone to local relapse. Therefore, surgical safety margins should be thoroughly assessed.

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“…In these cases, a painless decrease in visual acuity is the chief complaint of the patients. Beyond that, there are several reports of orbital and optic toxicity after intracarotid injection of platinum drugs [14,15]. In these cases, soft tissue hyperdensity of the orbital fat in CT scans indicated retroorbital swelling, presumably due to vasculitis of orbital soft tissue.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gastroesophageal Junction with HER2/neu Overexpression and Distinct Orbital and Optic Nerve Toxicity after Intravenous Administration of Cisplatin

Golombek¹,

Henker

Rehák

et al. 2019

Oncol Res Treat

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Background: Mixed adenoneuroendocrine carcinomas (MANECs) are rare malignancies with both neuroendocrine and non-neuroendocrine components. To date, the prognosis of gastroenteropancreatic MANECs remains dismal, and treatment options are mainly based on guidelines for the treatment of pure neuroendocrine carcinomas or small cell lung cancer. Established first-line therapy in the metastatic situation is cisplatin and etoposide. Platinum derivatives are known to cause a variety of side effects also involving the visual system. Severe orbital and optic nerve toxicities have been described mainly after intracarotid infusion of cisplatin. Case Report: Herein we report a rare case of a 60-year-old male patient suffering from MANEC of the gastroesophageal junction with HER2/neu overexpression who developed severe orbital and ocular neurotoxicity (grade 3 according to CTCAE v4.03) after intravenous cisplatin. Conclusion: We discuss diagnostic approaches and differential diagnoses in this clinical situation. Before starting treatment with intravenous and topical steroids, it is crucial to rule out meningeal and cerebral spread as well as paraneoplastic and endocrine syndromes.

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Severe ocular and orbital toxicity after intracarotid injection of carboplatin for recurrent glioblastomas

Abstract: When performing intracarotid injection of carboplatin, we must be aware of its potentially blinding ocular toxicity. It is recommended that further studies and investigations are undertaken in the effort to minimize such severe side effects.

Cited by 37 publications

References 7 publications

Vascular Distribution of Glioblastoma Multiforme at Diagnosis

Vascular Distribution of Glioblastoma Multiforme at Diagnosis

Treatment Outcomes of Locally Advanced Squamous Cell Carcinoma of the Ethmoid Sinus Treated with Anterior Craniofacial Resection or Chemoradiotherapy

A Rare Case of Mixed Adenoneuroendocrine Carcinoma (MANEC) of the Gastroesophageal Junction with HER2/neu Overexpression and Distinct Orbital and Optic Nerve Toxicity after Intravenous Administration of Cisplatin

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