玻璃体内化疗时代视网膜母细胞瘤的原发性动脉内化疗：五年经验
Primary Intra-Arterial Chemotherapy for Retinoblastoma in the Intravitreal Chemotherapy Era: Five Years of Experience.
作者信息
Dalvin Lauren A, Kumari Mamta, Essuman Vera Adobea, Shohelly Shipa Shormin, Ancona-Lezama David, Lucio-Alvarez J Antonio, Jabbour Pascal, Shields Carol L
机构信息
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
Ocul Oncol Pathol. 2019 Feb;5(2):139-146. doi: 10.1159/000491580. Epub 2018 Aug 21.
PURPOSE
To report our 5-year experience with intra-arterial chemotherapy (IAC) in the intravitreal chemotherapy (IvitC) era.
METHODS
Retrospective review of retinoblastoma treated with primary unilateral IAC in the IvitC era (2012-2017).
RESULTS
There were 34 eyes treated with IAC alone versus 20 eyes treated with IAC plus IvitC for vitreous seeds. IAC (IAC alone vs. IAC plus IvitC) consisted of melphalan (41 vs. 10%) or melphalan plus topotecan (59 vs. 90%, = 0.03). IvitC consisted of melphalan (60%) or melphalan plus topotecan (40%). Tumor control and globe salvage were achieved in 100% of group B and C eyes without IvitC. Despite more extensive vitreous seeds in the IvitC group ( < 0.01), comparison of IAC alone versus IAC plus IvitC revealed no difference in tumor control for group D (88 vs. 69%, = 0.36) or group E (67 vs. 100%, = 0.25) and no difference in globe salvage for group D (88 vs. 69%, = 0.36) or group E (58 vs. 57%, = 0.39).
CONCLUSIONS
IAC is effective as primary therapy for unilateral group B, C, D, and E retinoblastoma. IvitC is an important adjuvant therapy to achieve comparable globe salvage rates for group D and E eyes with persistent active vitreous seeds.
目的
报告我们在玻璃体内化疗（IvitC）时代进行动脉内化疗（IAC）的5年经验。
方法
回顾性分析在IvitC时代（2012 - 2017年）接受原发性单侧IAC治疗的视网膜母细胞瘤。
结果
34只眼仅接受IAC治疗，20只眼因玻璃体种植灶接受IAC联合IvitC治疗。IAC（单纯IAC与IAC联合IvitC）方案中，美法仑使用比例分别为41%和10%，或美法仑联合拓扑替康使用比例分别为59%和90%（P = 0.03）。IvitC方案中，美法仑使用比例为60%，或美法仑联合拓扑替康使用比例为40%。未接受IvitC的B组和C组眼中，肿瘤控制和眼球挽救率均达到100%。尽管IvitC组玻璃体种植灶更广泛（P < 0.01），但单纯IAC与IAC联合IvitC比较，D组（88% vs. 69%，P = 0.36）和E组（67% vs. 100%，P = 0.25）在肿瘤控制方面无差异，D组（88% vs. 69%，P = 0.36）和E组（58% vs. 57%，P = 0.39）在眼球挽救方面也无差异。
结论
IAC作为单侧B、C、D和E组视网膜母细胞瘤的主要治疗方法有效。IvitC是一种重要的辅助治疗方法，可使有持续性活跃玻璃体种植灶的D组和E组眼达到相似的眼球挽救率。
Zotero 插件