Liang Ting-Yi, Zhu Xiu-Yu, Hua Xu-Ming, Ji Xun-Da, Zhao Pei-Quan
Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Int J Ophthalmol. 2020 Feb 18;13(2):257-262. doi: 10.18240/ijo.2020.02.09. eCollection 2020.
To evaluate the efficacy and safety of combined intra-arterial chemotherapy (IAC) and intravitreal melphalan (IVM) for the treatment of advanced unilateral retinoblastoma.
This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral retinoblastoma. All patients were initially treated with IAC combined with IVM. The clinical status and complications were recorded at each visit.
The International Intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 eyes. All eyes showed severe cloud vitreous seeds at the first visit. The mean number of IAC cycles and intravitreal injections was 3.2 (range, 3-4) and 6 (range, 1-14), respectively. The median follow-up time was 29mo (range, 7-36mo). Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes (96.7%). Globe salvage was attained in 93.3% (28/30) eyes, and enucleation (=2) was performed due to neovascular glaucoma and persistent vitreous hemorrhage. Complications included retinal pigment epithelium (RPE) atrophy (=13; 43%), mild lens opacity (=7; 23%), vitreous hemorrhage (=5; 17%) and rhegmatogenous retinal detachment (=1; 3%). No extraocular tumor extension or metastasis occurred.
Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.
评估动脉内化疗（IAC）联合玻璃体内注射美法仑（IVM）治疗晚期单眼视网膜母细胞瘤的疗效和安全性。
这项回顾性研究纳入了30例中国晚期单眼视网膜母细胞瘤患者的30只连续患眼。所有患者均首先接受IAC联合IVM治疗。每次就诊时记录临床状况和并发症。
国际眼内视网膜母细胞瘤分类中，D组23只眼，E组7只眼。所有患眼初诊时均显示严重的玻璃体混浊伴种子样病变。IAC周期数和玻璃体内注射次数的平均值分别为3.2次（范围3 - 4次）和6次（范围1 - 14次）。中位随访时间为29个月（范围7 - 36个月）。30只眼中29只（96.7%）视网膜肿瘤和玻璃体种子样病变消退，治疗成功。93.3%（28/30）的患眼实现了眼球挽救，2只眼因新生血管性青光眼和持续性玻璃体出血而进行了眼球摘除。并发症包括视网膜色素上皮（RPE）萎缩（13只眼；43%）、轻度晶状体混浊（7只眼；23%）、玻璃体出血（5只眼；17%）和孔源性视网膜脱离（1只眼；3%）。未发生眼外肿瘤扩展或转移。
IAC联合IVM治疗晚期单眼视网膜母细胞瘤有效且安全。
