Intra-arterial chemotherapy for retinoblastoma in Australia: 11-year experience
Bibliographic record
Abstract
Background: Intra-arterial chemotherapy (IAC) is increasingly used in managing patients with retinoblastoma. In Australia, IAC is primarily used as a globe-salvage treatment when primary treatment has failed. Methods: A retrospective, single-institution study conducted on consecutive children treated with IAC at the Royal Children’s Hospital, Victoria, Australia between September 2009 to January 2021. Results: Using the Intraocular Classification of Retinoblastoma (ICRB), 16 eyes of 14 children classified as group A (n=1), Group B (n=3), Group D (n=10), or Group E (n=2) were treated with IAC. All but one child received IAC as secondary treatment for relapsed or refractory disease. Successful catheterisation of the ophthalmic artery was achieved in 37/46 (80.4%) procedures. A systemic complication occurred in one child (n=1): radiological evidence of a watershed infarct. Local complications of IAC included conjunctival injection (n=1), forehead rash (n=1), sixth cranial nerve palsy (n=2), ptosis (n=2), hemi-retinal ischaemia (n=1), choroidal ischaemia (n=1), retinal detachment (n=2), and choroidal neovascularisation (n=1). Regional extra-ocular disease occurred in one child. No child had distant metastatic disease and no child died. The overall globe salvage rate was 8/16 (50%): Group A (n=1, 100%), group B (n=2, 66.6%), Group D (n=5, 50%), group E (n=0, 0%). Kaplan Meier analysis of ocular survival following treatment with IAC was 75%, 68% and 53% for 6 months, 1 year and 2 years, respectively. Conclusions: Our experience demonstrates that IAC can be a useful treatment modality for refractory retinoblastoma in globe salvage, with an acceptable side-effect profile.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".