Not applicable, Experimental, Education and training, Technical aspects, Chemotherapy, Arterial access, Percutaneous, Catheter arteriography, Oncology, Interventional vascular, Eyes, Interventional Radiology
P. A. Rago1, J. Bartuszek2, E. Jurkiewicz1, U. H. Pasik1, J. Debska1; 1Warsaw/PL, 2Warszawa/PL
Methods and materials
The IAC has been performed under anticoagulation with intravenous heparin (70units/kilo till 2018, 50 units per kilo from 2019) with a 3,5F leading catheter in ICA and 1,2-1,5 catheter placed at the entrance to the ophthalmic artery. A preinfusion arteriogram is taken to confirm patency of the ophthalmic artery.
Chemotherapeutic agents diluted in saline are delivered to retina using a pulsation technique. The selected chemotherapy drugs are Melphalan (2-5 mg) combined with Topotecan (0,3-1 mg). Carboplatin (20-40 mg) is used as well in most cases. Drugs combinations were modified for children with bilateral retinoblastoma (under 20%)
The patient’s age ranged from 4 months to 7 years. Each of them was given from 1 to 6 doses of chemotherapy (over 85% 3 doses).At this point children are not excluded from this procedure in terms of age and weight. Until 2019 children under 5 months, and under 7 kg were excluded from this procedure.
The effectiveness of this procedure is evaluated by a complete eye examination, as well as MRI Imaging.