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视网膜母细胞瘤治疗进展:探索玻璃体内化疗的潜力

Advancements in Retinoblastoma Treatment: Unraveling the Potential of Intravitreal Chemotherapy.

作者信息

Tanveer Shafiq, Zafar Fahad, Bibi Hafsa, Haroon Hamza, Ahmad Obaid, Iqbal Muhammad Shahid, Zakir Zarafshan, Khilji Maryum, Tanveer Safina, Hassan Rao E

机构信息

Ophthalmology, Khyber Teaching Hospital MTI, Peshawar, PAK.

Surgery, Ayub Teaching Hospital, Abbottabad, PAK.

出版信息

Cureus. 2024 Jan 26;16(1):e53012. doi: 10.7759/cureus.53012. eCollection 2024 Jan.

Abstract

Retinoblastoma necessitates urgent attention due to its potential fatality if untreated. Multiple treatment options are available and should be employed according to size, location, and the extent of dissemination. This review emphasizes the need for increased awareness, advanced diagnostic tools, and innovative treatment approaches, especially intravitreal chemotherapy (IVitC) to address the diverse manifestations and aggressive nature of retinoblastoma. Timely diagnosis and commitment to treatment are pivotal, as delays and reluctance to undergo enucleation contribute to unfavorable outcomes. The evolving treatment landscape, spanning from traditional interventions to modern targeted therapies such as intravitreal melphalan, holds promise for improved outcomes. While the intravitreal approach presents challenges, ongoing research aims to establish its definitive role in retinoblastoma treatment. In the treatment of retinoblastoma, IVitC raises considerations about side effects. The risk of tumor spread beyond the eye is rare, emphasising the potential of IVitC in carefully selected cases. Intravitreal injections exhibit fewer local adverse effects compared to intra-arterial chemotherapy, with careful measures reducing significant ocular complications. The evaluation of ocular toxicity, particularly with melphalan, underscores the importance of a nuanced approach to achieve the right balance between therapeutic efficacy and ocular safety. This comprehensive analysis of studies on IVitC and its ocular and systemic complications provides valuable insights for enhanced patient care. The review concludes with a focus on balancing safety and efficacy in local chemotherapeutic drugs, highlighting the need for thoughtful measures and continued research to optimise treatment modalities globally.

摘要

视网膜母细胞瘤若不治疗有潜在致命风险,因此需要紧急关注。目前有多种治疗选择,应根据肿瘤大小、位置及扩散程度来采用。本综述强调需要提高认识、采用先进诊断工具和创新治疗方法,尤其是玻璃体内化疗(IVitC),以应对视网膜母细胞瘤的多样表现和侵袭性。及时诊断和积极治疗至关重要,因为延误和不愿接受眼球摘除会导致不良后果。从传统干预到现代靶向治疗如玻璃体内美法仑的不断发展的治疗格局,有望改善治疗结果。虽然玻璃体内治疗方法存在挑战,但正在进行的研究旨在确定其在视网膜母细胞瘤治疗中的明确作用。在视网膜母细胞瘤治疗中,IVitC引发了对副作用的关注。肿瘤扩散至眼外的风险罕见,这凸显了IVitC在精心挑选病例中的潜力。与动脉内化疗相比,玻璃体内注射的局部不良反应较少,通过谨慎措施可减少严重眼部并发症。对眼部毒性的评估,尤其是美法仑的评估,强调了采用细致方法在治疗效果和眼部安全之间取得恰当平衡的重要性。对IVitC及其眼部和全身并发症研究的全面分析为加强患者护理提供了宝贵见解。综述最后聚焦于平衡局部化疗药物的安全性和有效性,强调需要采取深思熟虑的措施并持续开展研究以在全球范围内优化治疗方式。

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