A research team at Severance Hospital has confirmed that intra-arterial chemotherapy can increase the ocular preservation rate up to 14 times in advanced retinoblastoma patients.
Retinoblastoma is a malignant retina tumor and the most common malignant tumor in the eye in children, with patients usually diagnosed at five or younger. About 40 percent of patients are hereditary, and the illness can occur in both eyes simultaneously or at intervals.
The international staging of retinoblastoma classifies the tumor into five groups -- A, B, C, D, and E -- according to the size and severity of the tumor.
With the development of chemotherapy, the number of eye removals to treat retinoblastoma has decreased significantly. However, systemic chemotherapy alone is insufficient for patients in the retinoblastoma group D or E, and hospitals have to consider eye removal in many cases. In addition, hospitals have to administer toxic chemotherapy to children several times due to the treatment burden and side effects.
To resolve this problem, the team -- led by Professors Lee Seung-kyu of the department of Ophthalmology, Han Jung-woon of the Department of Pediatric Hemato-oncology, and Kim Dong-jun of the Department of Radiology -- conducted intra-arterial chemotherapy for the first time in Korea in 2010.
The treatment involves administering a small dose of an anticancer drug directly into the ophthalmic artery to the eye to reduce side effects and increase the therapeutic effect.
The research team has compared the five-year eye retention rate and mortality rate of 33 eyes treated after introducing intra-arterial chemotherapy (2010-2020) and 64 eyes treated before introducing the surgery method (1985-2009).
The analysis showed that the five-year ophthalmologic preservation rate for patients not treated with intra-arterial chemotherapy was about 3.2 percent, while those that received the intra-arterial chemotherapy was about 44.5 percent.
“The focus of treatment for advanced retinoblastoma is to preserve the eyeball and maximize vision to help maintain a quality of life until adulthood,” Professor Lee said. “In the future, we will strive to develop various treatments such as systemic chemotherapy, intraocular chemotherapy, intravitreal chemotherapy, and brachytherapy while providing customized treatments according to patient characteristics.”
Journal of Clinical Medicine published the result of the study in its latest issue.