Yousef Yacoub A, Noureldin Amal M, Sultan Iyad, Deebajah Rasha, Al-Hussaini Maysa, Shawagfeh Munir, Mehyar Mustafa, Mohammad Mona, Jaradat Imad, AlNawaiseh Ibrahim
Departments of Surgery/Ophthalmology, King Hussein Cancer Centre (KHCC), Queen Rania Al-Abdullah Street, P.O. Box 1269, Amman 11941, Jordan.
Pediatrics Oncology, King Hussein Cancer Centre (KHCC), Queen Rania Al-Abdullah Street, P.O. Box 1269, Amman 11941, Jordan.
J Ophthalmol. 2020 Jan 24;2020:8628525. doi: 10.1155/2020/8628525. eCollection 2020.
To evaluate our experience with intravitreal melphalan chemotherapy as a second-line regimen for RB patients with refractory or recurrent vitreous seeds.
A retrospective case series of 16 eyes from 16 patients with intraocular RB who received intravitreal melphalan chemotherapy using the antireflux injection technique. Data included demographics, stage at diagnosis, treatment modalities, side effects, eye salvage, and survival.
The total number of injections was 64 (median, 3 injections per eye; range, 3-8), and the median age at time of injection was 22 months (range, 9-63 months). Nine (56%) patients were males, and 13 (81%) patients had bilateral RB. Complete response was seen in 13 (81%) eyes: in 9 (100%) eyes with focal vitreous seeds and in 4 (57%) eyes with diffuse vitreous seeds (=0.062). At a median follow-up of 18 months (range, 6-48 months), the eye salvage rate was 81%, local retinal toxicity confined to the site of injection was seen in 2/3 of the eyes, 2 (12%) eyes had cataract, and none of the patients had orbital recurrence and distant metastasis or was dead.
Intravitreal melphalan is a promising modality for treatment of vitreous seeds, and the dose of 20-30 g of melphalan sounds to be safe and effective for refractory and recurrent vitreous seeds.g of melphalan sounds to be safe and effective for refractory and recurrent vitreous seeds.
评估我们使用玻璃体内注射美法仑化疗作为视网膜母细胞瘤（RB）患者伴有难治性或复发性玻璃体种植的二线治疗方案的经验。
对16例眼内RB患者的16只眼进行回顾性病例系列研究，这些患者采用抗反流注射技术接受玻璃体内美法仑化疗。数据包括人口统计学资料、诊断时的分期、治疗方式、副作用、眼球挽救情况和生存率。
注射总数为64次（中位数，每只眼3次；范围，3 - 8次），注射时的中位年龄为22个月（范围，9 - 63个月）。9例（56%）患者为男性，13例（81%）患者患有双侧RB。13只眼（81%）出现完全缓解：9只眼（100%）为局限性玻璃体种植，4只眼（57%）为弥漫性玻璃体种植（P = 0.062）。中位随访18个月（范围，6 - 48个月）时，眼球挽救率为81%，2/3的眼出现局限于注射部位的局部视网膜毒性，2只眼（12%）发生白内障，无患者出现眼眶复发、远处转移或死亡。
玻璃体内注射美法仑是治疗玻璃体种植的一种有前景的方式，20 - 30μg美法仑的剂量对于难治性和复发性玻璃体种植似乎是安全有效的。g美法仑的剂量对于难治性和复发性玻璃体种植似乎是安全有效的。
