Kaneko Akihiro, Suzuki Shigenobu
Division of Ophthalmology, National Cancer Center Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2003 Dec;33(12):601-7.
Retinoblastoma with vitreous seeding has been one of the most challenging conditions for eye-preservation therapy. Several modalities for treating vitreous seeding were reviewed in order to analyze the problems associated with them. External beam radiotherapy has been the most reliable method to treat vitreous seeding. However, recurrence after external beam radiotherapy needs other types of treatments to preserve the eyeballs. Due to the progress of investigations concerning retinoblastoma, chemotherapy has become the most promising method to cure not only recurrence but also primary tumors. Systemic chemotherapy can rarely cure vitreous seeding, but local chemotherapy using vitreous injections of melphalan can preserve about 50% of the eyeballs with vitreous seeding. Currently, animal experiments are being conducted to study the efficacy and safety of vitreous surgery combined with infusion of anticancer drugs for eradication of vitreous seeds and maintenance of visual function.
伴有玻璃体播散的视网膜母细胞瘤一直是眼球保留治疗中最具挑战性的病症之一。为了分析与之相关的问题，对几种治疗玻璃体播散的方法进行了综述。外照射放疗一直是治疗玻璃体播散最可靠的方法。然而，外照射放疗后的复发需要其他类型的治疗来保留眼球。由于视网膜母细胞瘤研究的进展，化疗已成为不仅能治愈复发肿瘤而且能治愈原发性肿瘤最有前景的方法。全身化疗很少能治愈玻璃体播散，但通过玻璃体内注射美法仑进行局部化疗可使约50%伴有玻璃体播散的眼球得以保留。目前，正在进行动物实验以研究玻璃体手术联合抗癌药物输注根除玻璃体种子并维持视觉功能的疗效和安全性。
