Fulton Amy T, Maniar Arpita, Provenzano Alicia, Firosvi Tariq A, Rogers Julianne, Archambault Bridget, Liu Beiyu, Chow Shein-Chung, Landi Daniel B, Materin Miguel A, Hauck Erik F
Department of Neurosurgery, Duke University, Durham, NC, USA.
Department of Ophthalmology, Duke University, Durham, NC, USA.
Interv Neuroradiol. 2025 Mar 26:15910199251324028. doi: 10.1177/15910199251324028.
ObjectiveIntra-arterial chemotherapy (IAC) is a well-established treatment for retinoblastoma (RB). However, there are no standardized recommendations regarding the choice of drugs. This study compares the outcomes of single- versus multi-drug therapy.MethodsClinical data was reviewed for RB children treated with IAC at our institution between 2018 and 2023. Patients were divided into single- and multi-drug treatment groups. Clinical parameters included total number of IAC treatments, treatment-related adverse events, duration of additional post-IAC treatments, residual disease, recurrence, and the need for enucleation.ObservationsA total of 101 IAC treatments were included. Multi-drug therapy showed improved outcomes as compared to single-drug therapy, particularly in RB group B and C patients. After multi-drug IAC, less secondary treatment time was required compared to single-drug treatment (2.1 months versus 4.6 months; p = 0.019). Group B and C patients required a median of 8.5 fewer months of secondary treatment after multi- vs. single-drug IAC. Patients treated with multi-drug IAC had an overall lower rate of residual disease or recurrence compared to single-drug IAC patients (26.3% vs. 35.7% recurrence; 52.6% vs. 71.4% residual). In group B and C patients, the difference was more pronounced (12.5% vs. 40% recurrence; 37.5% vs. 60% residual). The overall success rate in preventing enucleation was 90.9%.ConclusionsIAC treatment for RB is safe and effective. IAC prevented enucleation in >90% of our patients. Multi-drug IAC patients required less secondary treatment post-IAC, particularly group B and C patients.
目的
动脉内化疗（IAC）是视网膜母细胞瘤（RB）一种成熟的治疗方法。然而，关于药物选择尚无标准化建议。本研究比较了单药与多药治疗的效果。
方法
回顾了2018年至2023年在我院接受IAC治疗的RB患儿的临床资料。将患者分为单药和多药治疗组。临床参数包括IAC治疗的总次数、治疗相关不良事件、IAC治疗后额外治疗的持续时间、残留疾病、复发情况以及眼球摘除的必要性。
观察结果
共纳入101次IAC治疗。与单药治疗相比，多药治疗显示出更好的效果，尤其是在B组和C组RB患者中。多药IAC治疗后，与单药治疗相比，所需的二次治疗时间更短（2.1个月对4.6个月；p = 0.019）。B组和C组患者在接受多药IAC与单药IAC治疗后，二次治疗时间中位数少8.5个月。与单药IAC患者相比，接受多药IAC治疗的患者残留疾病或复发的总体发生率更低（复发率：26.3%对35.7%；残留率：52.6%对71.4%）。在B组和C组患者中，差异更为明显（复发率：12.5%对40%；残留率：37.5%对60%）。预防眼球摘除的总体成功率为90.9%。
结论
IAC治疗RB安全有效。IAC在我们超过90%的患者中预防了眼球摘除。多药IAC治疗的患者IAC治疗后所需的二次治疗更少，尤其是B组和C组患者。
