The aim fo this study was to explore the clinical efficacy and complications of intravenous chemotherapy and intra-arterial chemotherapy for unilateral group D retinoblastoma.

60 patients (60 eyes) unilateral group D retinoblastoma patients diagnosed at Beijing Children′s Hospital affiliated to Capital Medical University from December 2018 to January 2021 were enrolled. Among of them, 32 cases (32 eyes) were male and 28 cases (28 eyes) were female, with mean age of (24.5±7.3) months (ranging from 10 to 40 months). All patients were assigned to two groups according to treatment modalities. The number of patients received intra-arterial chemotherapy (IAC), and intravenous chemotherapy (IVC) was half-half. Globe salvage, tumor control, treatment time, follow-up time and complications after different treatment modalities were recorded. Globe salvage rate, solid tumor control, subretinal seeds control, vitreous seeds control were computed. Globe salvage rate, solid tumor control, subretinal seeds control and vitreous seeds control were expressed with percentage, which was compared by Chi-square test. Treatment time was expressed by ±s , which was compared by two independent samples t-test.

The globe salvage rate of IAC group and IVC group were 86.7%(26/30) and 46.7%(14/30), respectively. There was a statistically significant differentce between them (χ²=10.800, P<0.05). Solid tumor control of IAC group and IVC group were 80%(24/30) and 43.3%(13/30), respectively. The difference between two groups was statistically significant between them (χ²=8.531, P<0.05). Subretinal seeds control of IAC group and IVC group were 78.9%(15/19) and 38.9%(7/18), respectively. There was a statistically significant differentce between them (χ²=6.153, P<0.05). Vitreous seeds control of IAC group and IVC group were 71.4%(15/21) and 36.8%(7/19), respectively. The difference between two groups was statistically significant (χ²=4.821, P<0.05). Treatment time in IAC group and IVC group were (3.30±1.48) months and(5.85±1.62)months, respectively. The difference between two groups was statistically significant (t=5.197, P<0.05). There were less systemic complications, mild ocular and periocular side effects in IAC group. Moreover, there were no patients with metastasis or death in either group. In IAC group, 4 globes were removed. The pathological result showed there was no high risk factor in 4 enucleated eyeball. In IVC group, 16 globes were removed. The pathological result showed 8 enucleated eyeballs had high risk factors.

For unilateral group D retinoblastoma, IAC provided significantly superior tumor control, globe salvage, less and mild complications compared with IVC.