Intra-arterial Chemotherapy (IAC) for Retinoblastoma

These instructions are for Children's Hospital of Philadelphia (CHOP) patients who receive intra-arterial chemotherapy for retinoblastoma.

Important information:

• Learn more about retinoblastoma

• Learn more about intra-arterial chemotherapy (IAC)

• Side effects of IAC include:

  • Swelling of the eyelids, light sensitivity or eye discomfort.

  • Increased risk for infection due to low blood counts (number of white blood cells, red blood cells, and platelets).

    • Your child will have blood counts checked every week for the first three weeks after IAC. Your healthcare team will tell you when to make appointments to get your child's blood counts checked.

  • Nausea or vomiting: You will receive a prescription for an oral medicine to treat nausea, called Zofran® (ondansetron).

  • Hair thinning or hair loss, including eyelashes. Hair will usually grow back when treatment is finished.

• Your child will begin taking an antibiotic called Bactrim TM (co-trimoxazole). This medicine is given to prevent pneumocystis pneumonia (PCP) in children that have received chemotherapy.

• Side effects of sedation can include constipation.

Instructions for after IAC:

• It is normal for your child's eye to be red and painful. If your child complains of eye pain, give Tylenol® for pain relief. Check your child's temperature first to be sure there is no fever.

• Call the healthcare team if the eye has any drainage (pus).

• Remove the bandage on your child's groin 48 hours after the procedure. Some bruising at the site is normal.

  • If there is bleeding after removing the bandage, apply pressure with a gauze pad until it stops.

  • Call your healthcare team if there is swelling, pus, or bleeding that does not stop after 5 minutes.

  • Wash the area with soap and water every day and apply a clean bandage for 1 week.

  • There will be dissolvable stitches at the site. No care is needed for the stitches.

  • Avoid tub baths and swimming for 3 days after the procedure.

• Wash hands often to prevent infection. Avoid being around visitors that are sick with a fever, respiratory symptoms, gastrointestinal (GI) symptoms, or a rash.

• Take your child's temperature if they do not look well. Take a temperature under the arm or tongue. Do not take a rectal temperature. Fever can be a sign of an infection.

  • Call your healthcare team if your child's temperature is: 101.3°F or higher once, or 100.4°F-101.2°F three times in 24 hours (taken 2 hours apart).

• Do not give your child acetaminophen (Tylenol®), or ibuprofen (Motrin®, Advil®, pediaprofen) for a fever unless instructed by the healthcare team.

• If your child is nauseous, give sips of cool, clear liquids such as Pedialyte®.

• Call the healthcare team if your child vomits multiple times or is unable to drink fluids, and has signs of dehydration:

  • No tears when crying

  • Urinating less than normal (less wet diapers)

  • Dark urine

• Call your healthcare team if your child has a change in his regular bowel movement pattern (not as often, not as much), pain when having a bowel movement, or passes a hard stool.

• It is recommended to wear gloves when changing your child's diaper and wash hands after diaper changes for the 48 hours after IAC. Chemotherapy is eliminated through your child's urine, stool and vomit.

Oncology Contact Information

8:30am-5:00pm, 7 days a week (including holidays)
215-590-2299 (select Phone Nurse)

Every day after 5:00pm, all patients
215-590-1000, ask the hospital operator for the Oncology Fellow on-call

Reviewed on March 1, 2022, by Amish Shah, MD