Intra-arterial Chemotherapy(Chemosurgery) for Retinoblastoma

checkorphan
Learn more about:
Retinoblastoma
Related Clinical Trial
Deep Learning in Retinoblastoma Detection and Monitoring. Adjuvant Chemotherapy for High-risk Postenucleation Retinoblastoma A Clinical Study on the Efficacy and Safety of VEC Intravenous Chemotherapy Combined With Conbercept Intravitreal Injection in the Treatment of Retinoblastoma RB Liquid Biopsy Biorepository Topotecan and Melphalan for Retinoblastoma Effect of Anesthetic Drugs on Neurocognitive Function in Children With Retinoblastoma Requiring Multiple Anesthetic Exposure – Preliminary Study Ocular Conservative Treatment for Retinoblastoma : Efficacy of the New Management Strategies and Visual Outcome Nitroglycerin for Intra-arterial Chemotherapy in Pediatric Retinoblastoma. Autonomic Reflexes During Intra-arterial Chemotherapy for Retinoblastoma Therapeutic Recommendations For The Treatment Of Children With A Retinoblastoma Photodynamic Therapy With Visudyne for Human Retinoblastoma: A Preliminary Study Topotecan Episcleral Plaque for Treatment of Retinoblastoma G-CSF Alone or Combination With GM-CSF on Prevention and Treatment of Infection in Children With Malignant Tumor Comprehensive Omics Analysis of Pediatric Solid Tumors and Establishment of a Repository for Related Biological Studies Chemotherapy Followed by Peripheral Stem Cell Transplantation in Treating Children With Newly Diagnosed Brain Tumor Mobile Health Case Management System for Reducing Pediatric Treatment Abandonment PCI Imaging System in Pediatric Ophthalmology Evaluate Safety and the Oncolitic Adenovirus VCN-01 Activity in Patients With Refractory Retinoblastoma Determining Whether Multiple Anesthesia Exposures Affect Cognitive Function for Retinoblastoma Patients Conservative Treatments of Retinoblastoma Study of Treatment for Patients With Cancer of the Eye -Retinoblastoma Intra-arterial Chemotherapy for Advanced Intraocular Retinoblastoma Photoscreening for Retinoblastoma RCT of Ballon Technique VS Selective Ophthalmic Artery Infusion For the Retinoblastoma Patients Studying Health Outcomes After Treatment in Patients With Retinoblastoma Chemotherapy Treatment for Children With Intraocular Germ-Line Retinoblastoma Genetic Mutations and Environmental Exposure in Young Patients With Retinoblastoma and in Their Parents and Young Healthy Unrelated Volunteers A Study of the Effectiveness of a Local Injection of Chemotherapy for Retinoblastoma Intra-arterial Chemotherapy for Retinoblastoma Intra-arterial Chemotherapy With Melphalan for the Treatment of Retinoblastoma (RTB) in Advanced Intraocular Stage Determination of the Sensitivity and Specificity of a Smartphone Application to Detect Retinoblastoma Phase I Trial of Periocular Topotecan in Retinoblastoma Episcleral Topotecan for Treatment of Group D Retinoblastoma Can Pretreatment MRI be Used to Predict Intra-arterial Chemotherapy Response in Retinoblastoma? CEV With/Without Periocular Carboplatin Chemotherapy for Extraocular Retinoblastoma Chemotherapy With or Without Radiation Therapy or Observation in Treating Young Patients With Advanced Retinoblastoma Who Have Undergone Surgery to Remove the Eye Combination Chemotherapy, Radiation Therapy, and Bone Marrow Transplantation in Treating Patients With Retinoblastoma Intravitreal Carboplatin for the Treatment of Participants With Recurrent or Refractory Intraocular Retinoblastoma Superselective Intra-arterial Chemotherapy Treatment for Retinoblastoma- 5 Year Results From Turkey Intra-arterial Chemotherapy(Chemosurgery) for Retinoblastoma Adjuvant Chemotherapy for High-risk Retinoblastoma After Enucleation Alternating Systemic Chemotherapy and Intra-Arterial Melphalan (IAM) Chemotherapy in Children With Intra-Ocular Retinoblastoma Chemotherapy in Treating Patients With Retinoblastoma New Strategies to Detect Cancers in Carriers of Mutations in RB1 Pilot Study of Topotecan/Vincristine With Subconjunctival Carboplatin for Patients With Bilateral Retinoblastoma Carboplatin Plus Vincristine in Treating Children With Retinoblastoma Combination Chemotherapy and Cyclosporine Followed by Focal Therapy for Bilateral Retinoblastoma Proton Beam Radiation Therapy for Intraocular and Periocular Retinoblastoma Quality of Life in Children Cured of Retinoblastoma Adjuvant Treatment in Extensive Unilateral Retinoblastoma Primary Enucleated (RB SFCE 2009) Cardio-respiratory Events During Ophthalmic Artery Chemotherapy for Retinoblastoma Under a Deep Anesthesia Protocol for the Study and Treatment of Participants With Intraocular Retinoblastoma SPT Screening in Irradiated Hereditary Retinoblastoma Survivors Attention to Retinoblastoma Diagnosed in the Trauma Setting Carboplatin Periocular Injection for Retinoblastoma Morphological Analysis of the Pineal Gland in Pediatric Retinoblastoma Patients Using Magnetic Resonance Imaging Phase II Study Temozolomide for Retinoblastoma Metastatic to the Central Nervous System for Patients From Guatemala Research on the Environment and Children’s Health: Retinoblastoma Intravitreal Injections of Melphalan for Retinoblastoma Efficacy Study of Lucentis in the Treatment of Retinoblastoma Feasibility of Generating Pluripotent Stem Cells From Patients With Familial Retinoblastoma A Study of Intra-Ophthalmic Artery Topotecan Infusion for the Treatment of Retinoblastoma Retinoblastoma Survivor Study: Assessment of General Health and Quality of Life Retinoblastoma Biomarker Study Cancer Biology of Retinoblastoma Intra-arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma Intra-arterial Chemotherapy for Children With Retinoblastoma Molecular Analysis of Retinoblastoma

Brief Title

Intra-arterial Chemotherapy(Chemosurgery) for Retinoblastoma

Official Title

Intra-arterial Chemotherapy(Chemosurgery) for Retinoblastoma

Brief Summary

      Conventional treatments of retinoblastoma involves laser photocoagulation, cryotherapy
      (freezing of the tumor), plaque radiotherapy,external beam radiotherapy, and intravenous
      chemotherapy. Enucleation (removing of the eye)is the last option when the tumor cannot be
      controlled otherwise. However,many children with retinoblastoma present with advanced
      intraocular disease for which enucleation is the only option. Intra-arterial chemotherapy
      (Chemosurgery)delivers anti-tumor drug directly into the ophthalmic artery (the artery
      feeding the eye) in order to increase the dose of drug reaching the tumor while minimizing
      toxicity to the rest of the body.

Detailed Description

      Present treatments for intraocular retinoblastoma cure 99% of children but have significant
      toxicity. Enucleation of the eye is effective but blinds the eye and leaves a lifelong
      cosmetic deformity. Radiation is associated with the subsequent development of fatal cancers.
      Systemic (intravenous)chemotherapy is used worldwide but experience with it has shown that
      the majority of eyes initially treated with chemotherapy still require additional treatments,
      such as radiation, laser, cryotherapy or even enucleation. In addition blood transfusions,
      secondary infections, insertion of ports and permanent hearing loss are now well reported.
      Three years ago we developed this technique of Chemosurgery for significantly increasing the
      dose of drug to the cancer while decreasing the dose of drug administered to children. This
      approach has decreased the need for enucleation in advanced eyes scheduled for enucleation
      with minimal systemic toxicity. We now offer treatment of both eyes simultaneously (in
      bilateral cases) and to eyes with less advanced disease and normal vision as an alternative
      to toxic systemic chemotherapy. In cases of very advanced ocular disease we will be using
      multiple drugs infused at the same session to increase tumor kill.

      Chemosurgery interventions are performed under general anesthesia. The femoral artery (artery
      at the groin) is punctured and a catheter (a small plastic tube)is advanced into the
      opthalmic artery (the artery of the eye)using fluoroscopic (X-ray) guidance. The drugs are
      injected directly into the opthalmic artery over a period of 30-45 min.The catheter is then
      removed, manual compression exerted to the femoral artery, the child is awaken and goes to
      recovery for 6 hours. The procedure is repeated every 3-4 weeks for a total of 2 to 6
      sessions according to tumor response. Since April 2006, our center has treated by
      chemosurgery 60 eyes in 52 patients with advanced intra-ocular retinoblastoma for which
      enucleation was considered.

Study Phase

Phase 1/Phase 2

Study Type

Interventional

Primary Outcome

tumor control

Secondary Outcome

 tumor control with vision

Condition

Retinoblastoma

Intervention

Intra-arterial Chemotherapy

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Recruitment Status

Procedure

Estimated Enrollment

100

Start Date

May 2006

Completion Date

July 2009

Primary Completion Date

July 2009

Eligibility Criteria

        Inclusion Criteria:

          -  advanced retinoblastoma in one or both eyes

          -  recurrent retinoblastoma after failure of conventional methods

        Exclusion Criteria:

          -  retinoblastoma judged curable by conventional methods

          -  patient judged unable to undergo the procedure

Gender

All

Ages

1 Month - N/A

Accepts Healthy Volunteers

No

Contacts

David H Abramson, MD, ,

Location Countries

United States

Location Countries

United States

Administrative Informations

NCT ID

NCT00901238

Organization ID

RTB1

Study Sponsor

Weill Medical College of Cornell University

Collaborators

 Memorial Sloan Kettering Cancer Center

Study Sponsor

David H Abramson, MD, Principal Investigator, Weill Cornell Medical College and Memorial Sloan-Kettering Cancer Center

Verification Date

December 2009