For years, researchers have sought an avenue to deliver chemotherapy directly to retinoblastoma tumors – cancers of the retina of the eye, which primarily affect children under age 5. It turns out that the body itself offers just such a route.
Physicians at Dana-Farber/Children’s Hospital Cancer Center (DF/CHCC) offer a procedure in which retinoblastoma patients receive potent doses of chemotherapy directly through the main artery that channels blood to the eye. The technique, pioneered in Japan and refined in the United States, may improve the chances of saving the affected eye and preventing blindness in it.
“Retinoblastoma is a rare cancer that strikes about 300 children in this country every year,” says Carlos Rodriguez-Galindo, MD, a pediatric oncologist at DF/CHCC who leads the retinoblastoma program with Deborah Vanderveen, MD, of Ophthalmology and Darren Orbach, MD, PhD, of Interventional Neuroradiology.
“While 99 percent of patients are cured, we want to increase the percentage whose eyes can be spared. Intra-arterial chemotherapy represents an important step toward that goal.”
Chemotherapy for retinoblastoma has traditionally been given intravenously. The drugs are carried by the bloodstream to the eye, where they attack the tumor. Though effective, this approach requires high doses of chemotherapy, which can produce side effects such as nausea and hair loss.
Delivering chemotherapy directly into the artery that feeds the eye enables physicians to use lower overall doses, but increase the amount that reaches the tumor, potentially making the therapy more effective and reducing side effects.
The procedure involves threading an ultra-thin catheter from the femoral artery, located in the thigh, to the artery feeding the eye. Patients receive the treatment under general anesthesia in three, one-hour visits. Among the small, select group of patients in the United States to have been treated with the procedure so far, doctors have had a high success rate in saving the affected eye.