Liu Qiu-ling, Wang Ya-feng, Mao Geng-sheng, Yang Xin-ji, Sun Yan-feng, Miao Li-xia, Wang Jun, Yuan Hai-lian, Li Yan-shan, Liu Hong-yan, Wang Xiao-ling, Zhao Fei
Department of Pediatrics, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China.
Zhonghua Er Ke Za Zhi. 2012 Oct;50(10):793-7.
To investigate the safety of treatment with ophthalmic artery cannulation for intra-arterial chemotherapy (IAC) for children with intraocular retinoblastoma (RB).
In the RB Treatment Center of General Hospital of Armed Police Forces between January 2009 and September 2011, 42 patients who were diagnosed intraocular RB and treated with ophthalmic artery cannulation for IAC, 8 patients were treated 1 circle, 31 patients were treated 2 circles and 3 patients were treated 3 circles (total, 96 times). Each month had IAC once. The ophthalmic and the whole body evaluations were performed during IAC and after IAC for each circle, the blood cell count, alanine aminotransferase (ALT), serum creatinine (Scr), CK-MB content before and after IAC for 1 circle, 2 circles and 3 circles were determined.
(1) In 52 eyes of 42 patients, 44 eyes (84.6%) were in remission. (2) Successful IAC was achieved in all cases, no severe side effects occurred during IAC. (3) The main ophthalmic complications were eyelid edema and blepharoptosis after IAC, the incidence for 1 circle was 18% (2/11) and 9% (1/11); for 2 circles was 29% (11/38) and 21% (8/38); for 3 circles was all 100% (3/3). The rare complications were vitreous hemorrhage and heterotropia, the incidence was all 2% (1/42). The incidence of eyelid edema and blepharoptosis had no significant differences for 1 circle IAC compared with 2 circles (P > 0.05); the incidence of eyelid edema and blepharoptosis had significant differences for 3 circles IAC compared with 2 circles and 1 circle (P < 0.01). (4) No fever, septicemia and other systemic toxic effects occurred. (5) ALT of 19% patients (8/42) elevated temporarily and CK-MB of 24% patients (10/42) increased. The blood cell counts, ALT, Scr, and CK-MB content before IAC had no significant differences compared with that at 24 h after IAC for 1 circle, 2 circles and 3 circles (P > 0.05).
Ophthalmic artery cannulation for IAC is a safe and effective method in treating intraocular stage retinoblastoma.
探讨眼动脉插管行眼内视网膜母细胞瘤（RB）动脉内化疗（IAC）的安全性。
2009年1月至2011年9月期间，在武警总医院RB治疗中心，42例诊断为眼内RB并接受眼动脉插管IAC治疗的患者，8例治疗1个疗程，31例治疗2个疗程，3例治疗3个疗程（共96次）。每月进行1次IAC。每个疗程IAC期间及之后均进行眼科及全身评估，测定1个疗程、2个疗程及3个疗程IAC前后的血细胞计数、丙氨酸转氨酶（ALT）、血清肌酐（Scr）、肌酸激酶同工酶（CK-MB）含量。
（1）42例患者的52只眼中，44只眼（84.6%）病情缓解。（2）所有病例IAC均成功，IAC期间未发生严重副作用。（3）主要眼科并发症为IAC后眼睑水肿和上睑下垂，1个疗程时发生率分别为18%（2/11）和9%（1/11）；2个疗程时分别为29%（11/38）和21%（8/38）；3个疗程时均为100%（3/3）。罕见并发症为玻璃体积血和斜视，发生率均为2%（1/42）。1个疗程IAC与2个疗程IAC相比，眼睑水肿和上睑下垂发生率无显著差异（P>0.05）；3个疗程IAC与2个疗程及1个疗程IAC相比，眼睑水肿和上睑下垂发生率有显著差异（P<0.01）。（4）未发生发热、败血症及其他全身毒性反应。（5）19%的患者（8/42）ALT暂时升高，24%的患者（10/42）CK-MB升高。1个疗程、2个疗程及3个疗程IAC前的血细胞计数、ALT、Scr及CK-MB含量与IAC后24小时相比无显著差异（P>0.05）。
眼动脉插管IAC是治疗眼内期视网膜母细胞瘤的一种安全有效的方法。
