• Carlos A Leal-Leal, Laura Asencio-López, Jesús Higuera-Calleja, Max Bernal-Moreno, Vanessa Bosch-Canto, Juan Chávez-Pacheco, Gabriela Isaac-Otero, and Maja Beck-Popovic.
• Oncology Service, Instituto Nacional de Pediatría, Mexico City, Mexico.
• Rev Invest Clin. 2016 May 1; 68 (3): 137-42.

IntroductionIntra-arterial chemotherapy is a novel therapeutic modality for retinoblastoma patients. Intra-arterial chemotherapy involves the administration of a super-selective drug through the ophthalmic artery, resulting in better ocular penetration and low systemic toxicity.ObjectiveThe aim of this report was to evaluate the feasibility of intra-arterial chemotherapy in a large referral center in Mexico City.MethodsWe included patients with bilateral retinoblastoma, one enucleation, and active disease in the other eye after at least two courses of systemic chemotherapy combined with topical treatments. All patients were treated with three courses of a combination of melphalan 4 mg and topotecan 1 mg. Patients were examined under general anesthesia three weeks after each chemotherapy cycle.ResultsFrom 14 eligible patients, three could not be treated due to inaccessibility of the ophthalmic artery. A complete response was observed in 5/11 patients, three in Stage C according to the International Classification for Intraocular Retinoblastoma, one in Stage D, and one in Stage B. The eyes of three patients were enucleated as a result of active/progressive disease, one in Stage B and two in Stage D. Eye preservation was 55% after a mean follow-up of 171 days (range 21-336).ConclusionsSuper-selective intra-arterial chemotherapy is safe and effective for preventing the enucleation of 55% of affected eyes in this group of patients.

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