<sup>106</sup>Ruthenium brachytherapy for ciliary recurrence with supraciliary effusion in retinoblastoma

Chhablani, Jay; Romanzo, A.; Balmer, Aubin; Pica, Alessia; Gaillard, Marie-Claire; Cozza, Raffaele; Moeckli, Raphaël; Munier, Francis L.

doi:10.3109/13816810.2010.499888

Cited by 10 publications

(9 citation statements)

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“…Therefore, we propose a specific classification for relapsing retinoblastoma based on its localization which is detailed in Table 6. In this classification, the recognition of tumor relapse does not only rely on clinical observation but also on imaging devices such as UBM (Chhablani et al, 2010;Stathopoulos et al, 2018b) or SD-OCT (Fabian et al, 2017b;Gaillard et al, 2018). The definition of relapse or recurrence refers to any tumor regrowth or new growth occurring after a minimum of 2 months progression-free and treatment-free follow-up at a monthly examination.…”

Section: Group Bmentioning

confidence: 99%

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Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Munier

Beck‐Popovic

Chantada

et al. 2019

Progress in Retinal and Eye Research

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160

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Retinoblastoma is lethal by metastasis if left untreated, so the primary goal of therapy is to preserve life, with ocular survival, visual preservation and quality of life as secondary aims. Historically, enucleation was the first successful therapeutic approach to decrease mortality, followed over 100 years ago by the first eye salvage attempts with radiotherapy. This led to the empiric delineation of a window for conservative management subject to a "state of metastatic grace" never to be violated. Over the last two decades, conservative management of retinoblastoma witnessed an impressive acceleration of improvements, culminating in two major paradigm shifts in therapeutic strategy. Firstly, the introduction of systemic chemotherapy and focal treatments in the late 1990s enabled radiotherapy to be progressively abandoned. Around 10 years later, the advent of chemotherapy in situ, with the capitalization of new routes of targeted drug delivery, namely intra-arterial, intravitreal and now intracameral injections, allowed significant increase in eye preservation rate, definitive eradication of radiotherapy and reduction of systemic chemotherapy. Here we intend to review the relevant knowledge susceptible to improve the conservative management of retinoblastoma in compliance with the "state of metastatic grace", with particular attention to (i) reviewing how new imaging modalities impact the frontiers of conservative management, (ii) dissecting retinoblastoma genesis, growth patterns, and intraocular routes of tumor propagation, (iii) assessing major therapeutic changes and trends, (iv) proposing a classification of relapsing retinoblastoma, (v) examining treatable/preventable disease-related or treatment-induced complications, and (vi) appraising new therapeutic targets and concepts, as well as liquid biopsy potentiality.

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Section: Group Bmentioning

confidence: 99%

“…16). Whereas iris invasion can be controlled by intraarterial melphalan (Munier et al, 2018), ciliary body involvement needs to be treated by brachytherapy alone (Chhablani et al, 2010) if isolated, or by combining brachytherapy and intracameral chemotherapy if associated with aqueous seeding (Munier et al, 2018).…”

Section: Prevalence Of Anterior Uvea Invasionmentioning

confidence: 99%

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Munier

Beck‐Popovic

Chantada

et al. 2019

Progress in Retinal and Eye Research

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160

157

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“…In addition, retinoblastoma growth extending anteriorly to the ciliary body can cause a contaminated supraciliary effusion. 3 Extra-ocular retinoblastoma may seed in two different anatomic sites: (1) anteriorly into the amniotic fluid in the case of fetal fungating retinoblastoma, 4 , 5 and (2) posteriorly in the case of retro-laminar invasion with seeding into the circulating subarachnoidal fluid and progress from localized micrometastasis (stage IIN3) with negative lumbar punction cytology 6 to diffuse CNS disease with leptomeningeal carcinomatosis (stage IVb3). Alternatively, direct seeding into the CSF can occur from a pinealoblastoma or a parasellar tumor in the case of trilateral retinoblastoma.…”

Section: The Seeding Anatomic Sitesmentioning

confidence: 99%

Classification and Management of Seeds in RetinoblastomaEllsworth Lecture Ghent August 24th 2013

Munier

2014

Ophthalmic Genetics

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Retinoblastoma has the unique capacity to accelerate its own intra-ocular propagation by adopting semi-solid or even liquid growth properties through seeding. Until recently, the presence of any degree of seeding was mostly incompatible with successful conservative management, due to the multiresistant nature of the seeds. Surprisingly, this well-recognized retinoblastoma behavior has not undergone any detailed description of seeding patterns and anatomic sites. In this paper, we describe the phenotypic variability of seeds across the four possible intraocular seeding compartments and classify them into three fundamental types: namely dust, spheres, and clouds. We also provide an overview of the different therapeutic strategies developed for seeding, with special attention to intravitreal chemotherapy as the treatment of choice for vitreous and retro-hyaloid seeding. Finally, we propose criteria to enable assessment of the response to treatment by reporting seed regression patterns, as well as a clinical grading system for the retinal toxicity observed following intravitreal melphalan.

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“…Based on our knowledge, except in 2 published case reports [2,9], saving the eyes were not feasible for patients with clinically diagnosed choroidal invasion; therefore, enucleation had been inevitable [3,4,6,7]. In our patient, after observing a recurrence in the area close to the ciliary body, the patient had undergone two unsuccessful courses of IAC.…”

Section: Discussionmentioning

confidence: 72%

A New Rapidly Growing Dome-Shaped Choroidal Lesion in an Eye with Treated Retinoblastoma

Masoomian

Pefkianaki

Ghassemi

et al. 2021

Case Reports in Ophthalmological Medicine

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Background. To describe an extensive untreatable choroidal metastasis by retinoblastoma in the treated patient which was clinically indistinguishable from regular tumor recurrence. Methods. A 24-month-old girl without a family history of retinoblastoma (RB) was discovered to have group C RB in her right eye and group D in her left eye. The patient received 12 cycles of intravenous chemotherapy, intra-arterial chemotherapy (IAC), and intravitreal chemotherapy for the left eye and focal adjuvant therapy (laser thermotherapy and cryotherapy) for both eyes. Six months after the last treatment, fundus examination showed a regressed tumor in both eyes. Ten months after the last treatment, except for in addition to tumor recurrence, rising intraocular pressure was noticed in the left eye. While doing IAC for the left eye, a very rapid growing yellowish dome-shaped mass was found which had doubled in size in two weeks. Enucleation was considered for her. Results. Pathology evaluation of the enucleated eye revealed a very massive dome-shaped choroidal metastasis invasion with poorly differentiated RB tumor. Prophylactic systemic chemotherapy was performed for the patient. Conclusion. Choroidal metastasis in RB patients is often diagnosed based on pathology reports, but it may rarely be seen in clinical examinations especially if the pattern of tumor recurrence and growth is abnormal.

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¹⁰⁶Ruthenium brachytherapy for ciliary recurrence with supraciliary effusion in retinoblastoma

Abstract: This is the first clinical demonstration of supraciliary effusion in recurrent retinoblastoma. Brachytherapy appears to be effective in the treatment of this type of recurrence.

Cited by 10 publications

References 10 publications

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Classification and Management of Seeds in RetinoblastomaEllsworth Lecture Ghent August 24th 2013

A New Rapidly Growing Dome-Shaped Choroidal Lesion in an Eye with Treated Retinoblastoma

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106Ruthenium brachytherapy for ciliary recurrence with supraciliary effusion in retinoblastoma

Abstract: This is the first clinical demonstration of supraciliary effusion in recurrent retinoblastoma. Brachytherapy appears to be effective in the treatment of this type of recurrence.

Cited by 10 publications

References 10 publications

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Classification and Management of Seeds in RetinoblastomaEllsworth Lecture Ghent August 24th 2013

A New Rapidly Growing Dome-Shaped Choroidal Lesion in an Eye with Treated Retinoblastoma

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¹⁰⁶Ruthenium brachytherapy for ciliary recurrence with supraciliary effusion in retinoblastoma