Intra-arterial Chemotherapy Combined With VEC Intravenous Chemotherapy in the Treatment of Advanced Retinoblastoma

J BUON. Mar-Apr 2020;25(2):1199-1205.

Abstract

Purpose: To explore the efficacy and safety of intra-arterial chemotherapy (IAC) combined with vincristine + etoposide + carboplatin (VEC) intravenous chemotherapy (IVC) in the treatment of advanced retinoblastoma (RB).

Methods: A total of 86 child patients (98 eyes) newly diagnosed with advanced RB (stage D and E), among whom 42 cases (49 eyes) underwent IVC and IAC combined with local ocular treatment (IVC+IAC group), and 44 cases (49 eyes) were treated with IAC combined with local ocular treatment (IAC group). At 4 weeks after treatment, the maximum diameter and thickness of the tumor were evaluated, the expression levels of serum markers [vascular endothelial growth factor (VEGF), neurone specific enolase (NSE), Livin and Survivin] were assessed.

Results: The maximum diameter and thickness of the tumor significantly declined in patients after treatment compared with those before treatment. The maximum diameter and thickness of the tumor in IVC+IAC group were significantly smaller than those in IAC group after treatment. In the two groups, the eye salvage rate was 85.7% (42/49) and 79.6% (39/49), respectively. The recurrence rate was 12.2% and 18.4%, respectively, and the metastasis and mortality rate were all 2.0%. The levels of serum VEGF, NSE, Livin and Survivin were obviously decreased in both groups after treatment compared with those before treatment, while they were significantly lower in IVC+IAC group than those in IAC group after treatment.