Hahn Seung Min, Kim Hyo Sun, Kim Dong Joon, Lee Sung Chul, Lyu Chuhl Joo, Han Jung Woo
a Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System , Seoul , Korea.
b Department of Pediatric Hemato-Oncology , Yonsei Cancer Center, Yonsei University Health System , Seoul , Korea.
Pediatr Hematol Oncol. 2016 Feb;33(1):74-82. doi: 10.3109/08880018.2015.1135363. Epub 2016 Feb 22.
The recent trend of treatment for retinoblastoma is to salvage the eye globes as well as achieving patients' survival. Intra-arterial chemotherapy (IAC) is one of the current standard treatment; however, it cannot exclude the risk of occult micrometastases in the central nervous system in advanced-stage retinoblastoma. Alternate fashion of intravenous chemotherapy (IVC) and IAC strategy was developed to increase the eye salvage rate and to reduce the metastatic risk. Between January 2012 and December 2014, 13 eyes of 12 patients with newly diagnosed retinoblastoma received alternate chemotherapy using IVC and IAC in Yonsei Cancer Center. Eye salvage rate was assessed by the eye preservation time, which was defined as the duration from the diagnosis to the time of enucleation. Total 13 eyes were classified according to the International Classification of Retinoblastoma (ICRB) as group B (n = 1, 7.7%), group C (n = 2, 15.4%), group D (n = 5, 38.5%), or group E (n = 5, 38.5%). IAC was performed, 3 to 5 times (median: 4 times) for each eye, total 54 times. Five to 15 courses (median: 8 courses) of systemic chemotherapy were performed in the patients. During the median follow-up period of 30.4 months, overall eye salvage rate was 63.9 ± 14.7%. All patients survived. The treatment was tolerable without significant complications. These results showed that primary alternate IVC-IAC was tolerable and effective for retinoblastoma.
视网膜母细胞瘤的近期治疗趋势是在挽救患者生命的同时保住眼球。动脉内化疗（IAC）是当前的标准治疗方法之一；然而，它无法排除晚期视网膜母细胞瘤患者中枢神经系统隐匿性微转移的风险。为了提高眼球挽救率并降低转移风险，人们开发了静脉化疗（IVC）和IAC联合的替代治疗方案。2012年1月至2014年12月期间，延世癌症中心12例新诊断为视网膜母细胞瘤的患者的13只眼睛接受了IVC和IAC联合的替代化疗。通过眼球保留时间评估眼球挽救率，眼球保留时间定义为从诊断到眼球摘除的持续时间。根据国际视网膜母细胞瘤分类（ICRB），13只眼睛被分为B组（n = 1，7.7%）、C组（n = 2，15.4%）、D组（n = 5，38.5%）或E组（n = 5，38.5%）。每只眼睛进行3至5次IAC（中位数：4次），共进行54次。患者接受了5至15个疗程（中位数：8个疗程）的全身化疗。在30.4个月的中位随访期内，总体眼球挽救率为63.9±14.7%。所有患者均存活。该治疗耐受性良好，无明显并发症。这些结果表明，原发性IVC-IAC联合治疗对视网膜母细胞瘤耐受性良好且有效。
