Recent reports have raised some concerns about the risk of ocular vasculopathy, radiation-related toxicity, and the potential for metastatic disease (retinoblastoma relapse) after intraarterial chemotherapy.
All therapies have pros and cons, risks and benefits. The challenge of the patient and/or survivor is to understand those risks and benefits in order to make the best possible decisions for them. Please remember that your oncologist or oncologic surgeon may be biased in favor of the therapy that he/she is recommending. I don’t intend for that statement to sound negative in any way. I’m simply saying that, in general, oncologists want to treat and surgeons want to cut. Its what they do.
It is the patient/caregiver’s job to sort through possible bias to figure out what is best for them.
This study/article linked and excerpted below reviews the potential benefits and risks related to intra-arterial chemotherapy for retinoblastoma. While the treatment minimizes systemic toxicity as the chemotherapy is administered directly into the ophthalmic artery, recent studies show that the potential for metastatic diseases increases significantly.
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Retinoblastoma and Evidence-based Non-toxic Therapy to Reduce Relaps
Are retinoblastoma survivors genetically predisposed to secondary cancers?
New Cancer Researcher Challenges Conventional Retinoblastoma Thinking
“Retinoblastoma (Rb) is a rapidly developing cancer that develops in the cells of retina, the light-detecting tissue of the eye. In the developed world, Rb has one of the best cure rates of all childhood cancers (95-98%), with more than nine out of every ten sufferers surviving into adulthood…”
“Abstract- Retinoblastoma is a deadly eye cancer in children, leading to death in 50%-70% of children in undeveloped nations who are diagnosed with it. This malignancy is the most common intraocular tumor in childhood worldwide.
The good prognosis in developed nations is related to early detection and advanced treatments. With the advent of intraarterial chemotherapy, neurosurgeons have taken a central role in the treatment of this pediatric condition. Intraarterial chemotherapy is a novel treatment for retinoblastoma whereby chemotherapeutic agents are precisely delivered into the ophthalmic artery, minimizing systemic toxicity.
This procedure has shown impressive results and has allowed a dramatic decrease in the rate of enucleation (eye removal) in advanced and refractory retinoblastoma. Recent reports have raised some concerns about the risk of ocular vasculopathy, radiation-related toxicity, and the potential for metastatic disease after intraarterial chemotherapy. In the authors’ experience of more than 3 years, tumor control is excellent with globe salvage at 67% and vascular events less than 5%, mostly related to improvement in technique. The role of this novel approach in the management of retinoblastoma has yet to be defined. As more centers are adopting the technique, the topic will decidedly become the focus of intensive future research. In this paper, the authors review and discuss current data regarding intraarterial chemotherapy for retinoblastoma.”