A meta-analysis of the efficacy of intra-arterial chemotherapy for the management of retinoblastoma patients.

BACKGROUND

Intra-arterial chemotherapy (IAC) is considered a unique technique for retinoblastoma (Rb) management and has widespread applicability as a first-line or second-line treatment due to the high globe survival rates.

OBJECTIVES

This meta-analysis aimed to assess the efficacy of IAC approach among patients with Rb.

MATERIAL AND METHODS

This study outlined the most recent research on IAC effectiveness in Rb treatment. We carried out a systematic search for published papers examining IAC treatment among patients with Rb using electronic search engines, including Embase, Web of Science (WoS), PubMed, OVID, and Google Scholar, until October 2021.

RESULTS

This meta-analysis included 39 observational studies with 2604 treated eyes and 3112 individuals who were eligible for inclusion. Enucleation rates varied from 0% to 43.7% in the chosen trials, with an odds ratio (OR) of 0.52 (95% confidence interval (95% CI): 0.41-0.66, p < 0.0001). A range of 30-100% was reported for globe salvage across 27 investigations involving 2310 eyes. The estimated OR of globe salvage was 2.41, with 95% CI of 1.6-3.63 and a p-value <0.0001. The combined total effect sizes and the death rate for the proportion of cases with metastatic Rb were as follows: OR = 0.03 (95% CI: 0.03-0.03) and OR = 0.05 (95% CI: 0.04-0.05, p < 0.0001), respectively.

CONCLUSION

Retrospective trials have shown that intra-arterial-based therapy for Rb is an effective choice. Intra-arterial chemotherapy also reduced enucleation and metastasis incidence rates. The paucity of evidence in the literature necessitates further high-level studies.