Periocular topotecan for vitreous seeds in retinoblastoma
Purpose: Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma. Methods: Retrospective, interventiona...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=12;spage=1833;epage=1838;aulast=Sthapit |
| _version_ | 1818544859051458560 |
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| author | Purnima R Sthapit Raksha Rao Santosh G Honavar |
| author_facet | Purnima R Sthapit Raksha Rao Santosh G Honavar |
| author_sort | Purnima R Sthapit |
| collection | DOAJ |
| description | Purpose: Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma. Methods: Retrospective, interventional study of patients with retinoblastoma with vitreous seeds who received POT concurrent with intravenous chemotherapy (IVC). Results: Thirty-eight eyes of 35 patients received POT. Five eyes (13%) belonged to International Classification of Retinoblastoma group C, 23 eyes (61%) belonged to group D, and 10 eyes (26%) belonged to group E. Primary treatment included IVC with a combination of carboplatin, etoposide, and vincristine for a mean of 6 cycles (median 6; range 6–9). Concurrent to IVC from the fourth cycle onward, all patients received POT. Focal vitreous seeds were present in 20 eyes (53%) which received a mean of 3 injections (median 3; range 1–7). Diffuse vitreous seeds were present in 18 eyes (47%) which received a mean of 4 injections (median 5; range 1–7). At a mean follow-up of 8.5 months (median 5 months; range 1–15 months), regression of focal and diffuse vitreous seeds was achieved in 16 eyes (80%) and 8 eyes (44%), respectively. In all, 24 eyes (63%) had complete remission of vitreous seeds with POT given concurrently with IVC. Eye salvage was possible in 19 eyes (95%) with focal vitreous seeds and 12 eyes (68%) with diffuse VS. Enucleation was necessary for persistent vitreous seeds and viable tumor in five eyes (13%), viable tumor alone in one eye (0.02%), and recurrent vitreous seeds in one eye (0.02%). None of the patients developed systemic metastasis. Conclusion: POT administered concurrent with IVC is safe and effective in the initial management of vitreous seeds. |
| first_indexed | 2024-12-11T22:53:57Z |
| format | Article |
| id | doaj.art-7e027dc2d22a48c3814a6606d6ee2c78 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-12-11T22:53:57Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-7e027dc2d22a48c3814a6606d6ee2c782022-12-22T00:47:20ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892018-01-0166121833183810.4103/ijo.IJO_737_18Periocular topotecan for vitreous seeds in retinoblastomaPurnima R SthapitRaksha RaoSantosh G HonavarPurpose: Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma. Methods: Retrospective, interventional study of patients with retinoblastoma with vitreous seeds who received POT concurrent with intravenous chemotherapy (IVC). Results: Thirty-eight eyes of 35 patients received POT. Five eyes (13%) belonged to International Classification of Retinoblastoma group C, 23 eyes (61%) belonged to group D, and 10 eyes (26%) belonged to group E. Primary treatment included IVC with a combination of carboplatin, etoposide, and vincristine for a mean of 6 cycles (median 6; range 6–9). Concurrent to IVC from the fourth cycle onward, all patients received POT. Focal vitreous seeds were present in 20 eyes (53%) which received a mean of 3 injections (median 3; range 1–7). Diffuse vitreous seeds were present in 18 eyes (47%) which received a mean of 4 injections (median 5; range 1–7). At a mean follow-up of 8.5 months (median 5 months; range 1–15 months), regression of focal and diffuse vitreous seeds was achieved in 16 eyes (80%) and 8 eyes (44%), respectively. In all, 24 eyes (63%) had complete remission of vitreous seeds with POT given concurrently with IVC. Eye salvage was possible in 19 eyes (95%) with focal vitreous seeds and 12 eyes (68%) with diffuse VS. Enucleation was necessary for persistent vitreous seeds and viable tumor in five eyes (13%), viable tumor alone in one eye (0.02%), and recurrent vitreous seeds in one eye (0.02%). None of the patients developed systemic metastasis. Conclusion: POT administered concurrent with IVC is safe and effective in the initial management of vitreous seeds.http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=12;spage=1833;epage=1838;aulast=SthapitPeriocular injectionretinoblastomatopotecanvitreous seeds |
| spellingShingle | Purnima R Sthapit Raksha Rao Santosh G Honavar Periocular topotecan for vitreous seeds in retinoblastoma Indian Journal of Ophthalmology Periocular injection retinoblastoma topotecan vitreous seeds |
| title | Periocular topotecan for vitreous seeds in retinoblastoma |
| title_full | Periocular topotecan for vitreous seeds in retinoblastoma |
| title_fullStr | Periocular topotecan for vitreous seeds in retinoblastoma |
| title_full_unstemmed | Periocular topotecan for vitreous seeds in retinoblastoma |
| title_short | Periocular topotecan for vitreous seeds in retinoblastoma |
| title_sort | periocular topotecan for vitreous seeds in retinoblastoma |
| topic | Periocular injection retinoblastoma topotecan vitreous seeds |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2018;volume=66;issue=12;spage=1833;epage=1838;aulast=Sthapit |
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