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Retinoblastoma (RB) is the most common primary ocular malignancy in children.Many treatment modalities have been applied to RB.As an exciting option to reduce systemic adverse effects and increase the local drug concentration, intra-arterial chemotherapy (IAC) was introduced as an important treatment modality for advanced intraocular RB in recent years.
The aim of the study was to review the reported efficiency and safety of IAC in the treatment of RB.
Based on the established search strategy, we searched the electronic databases of PubMed, Medline, Embase, EBSCO, Web of Science, Wan Fang database, China National Knowledge Infrastructure, China Science and Technology Journal Database and China Biology Medicine disc.All the databases were retrieved from inception until April 2016.Study selection, data extraction, quality assessment and data analysis were performed according to preferred reporting items for systematic reviews and Meta-analyses (PRISMA) statement.
We included 27 studies reporting more than 1 067 RB patients (1 314 eyes) and over 3 818 IAC treatments.The overall salvage rate achieved 70.3% for all eyes, 76.2% for first-line IAC, 57.5% for more advanced RB and 76.4% for patients who did not receive other treatments during or after IAC.Metastases were reported in 23 patients and deaths were reported for 21 patients.Minor systemic complications (such as nausea or vomiting, neutropenia) and local complications (such as retinal pigment epithelium change, conjunctival chemosis and retinal detachment) were frequently reported, but there were few serious systemic complications.
IAC is a promising salvage therapy for RB without serious systemic complications.However studies with prospective design and long-term follow-up are still needed to identify the proper indication of IAC.