H.U.P. La Fe, Pharmacy Department, Valencia, Spain.
H.U.P. La Fe, Paediatric Oncology Department, Valencia, Spain.
J Oncol Pharm Pract. 2020 Dec;26(8):1829-1835. doi: 10.1177/1078155220904410. Epub 2020 Feb 17.
Retinoblastoma is the most common paediatric ocular tumour, which appears in the retina. Without treatment, retinoblastoma grows and destroys the internal ocular globe architecture, even leading to metastasis. When treated, overall survival is close to 97%, the alkylating drug melphalan being the most extensively used chemotherapeutic agent in localised treatment. The aim of this study is to describe the implementation of a new intravitreal chemotherapy retinoblastoma treatment protocol for children implanting vitreous seeds through intravitreal melphalan injections and to evaluate the patients' health outcomes treated with it. Between December 2014 and July 2018, seven patients were treated with this protocol. They received a mean of 3.3 cycles of intravitreal melphalan with standard doses of 30 mcg per cycle. In the seven eyes treated in our hospital, the response was as expected; three eyes with vitreous seedings (43%) were successfully treated. The main adverse effects presented by all patients were scars at cryogenisation points. In two patients, the appearance of 'salt and pepper' retinopathy was reported. Oncology pharmacists, as part of the treatment team, can provide information about recommended doses, expected adverse effects, stability of preparations, most appropriate method of processing, packaging, and methods of drug administration, to ensure efficacy and especially safety in the administration of these drugs.
视网膜母细胞瘤是最常见的小儿眼部肿瘤，发生于视网膜。如果不治疗，视网膜母细胞瘤会生长并破坏眼球内部结构，甚至导致转移。经过治疗，整体存活率接近 97%，烷化剂药物美法仑是局部治疗中最广泛使用的化疗药物。本研究旨在描述为儿童实施新的玻璃体内化疗治疗视网膜母细胞瘤方案的过程，该方案通过玻璃体内注射美法仑来植入玻璃体内种子，并评估使用该方案治疗的患者的健康结果。2014 年 12 月至 2018 年 7 月，7 名患者采用该方案进行治疗。他们平均接受了 3.3 个周期的玻璃体内美法仑治疗，每个周期的标准剂量为 30mcg。在我们医院治疗的 7 只眼中，反应如预期一样；3 只眼睛的玻璃体内种子（43%）成功得到治疗。所有患者的主要不良反应都是冷冻点的疤痕。有 2 名患者报告出现“椒盐”样视网膜病变。肿瘤药剂师作为治疗团队的一员，可以提供关于推荐剂量、预期不良反应、制剂稳定性、最适宜的处理方法、包装以及药物给药方法的信息，以确保这些药物给药的疗效和安全性，特别是安全性。
