First experience of local chemotherapy in children with intraocular retinoblastoma

DOI: https://doi.org/10.25512/DIR.2011.05.4.13

For quoting:
Ushakova T.L., Irofimov I.A., Gorovtzova O.V., Yarovoy A.A., Panferova T.R., Saltanov A.I., Dolgushin B.I., Poliakov V.G. "First experience of local chemotherapy in children with intraocular retinoblastoma". Journal Diagnostic & interventional radiology. 2011; 5(4); 77-83.

authors:

Ushakova T.L.

Irofimov I.A.

Gorovtzova O.V.

Yarovoy A.A.

Panferova T.R.

Saltanov A.I.

Dolgushin B.I.

Poliakov V.G.

keywords:

retinoblastoma

local chemotherapy

melphalan

laser treatment

Abstract:

Aim. Was to describe the efficiency of conservative treatment of retinoblastoma (RB) by an association of local chemotherapy (LCT) as an alternative method for external beam radiation (EBR) therapy and enucleation. Also to reduce the local and systemic side effects of chemotherapy.

Materials and methods. Seven children (11 eyes) had intraocular RB. All of them underwent LCT at the Institute of pediatric oncology and hematology of the N.N. Blokhin Russian Cancer Research Center between February and 2011. There were two methods of LC -selective intra-arterial chemotherapy (Institute of clinical oncology of the N. N. Blokhin Russian Cancer Research Center) and intravitrea chemotherapy by melphalan.LCT was made after systemic chemotherapy in4of8 patients with advanced RB with clinica stages T2a or group С (n = 1), T2b or group D (n = 3), T2c or group E (n = 3) as an alternative to EBR therapy Other 4 of 8 patients were treated with LCT as alternative to enucleation because of new retinal, subretinal tumors and vitreous seeding after initial treatment - systemic chemotherapy with laser treatment or in combination with brachytherapy and/or EBR therapy. LCT was combined with brachytherapy (106Ru + 10^о) in one case (S. Fyodorov Eye Microsurgery Complex)

Results. Due to using of alternative conservative RB treatment we have saved 8 children with 10 of 11 eyes with indications for EBR therapy or enucleation. There were not systemic side effects of LCT. Ophthalmic complications were minimal, including lid and face hyperemia after intra-arterial chemotherapy.

Conclusion. LCT with melphalan has shown high effectiveness as a method of globe-conserving treatment of locally spread RB with a minimum of immediate complications. A small number of observations and the maximum period of observation 7 months do not allow to reliably estimate the long-term results of treatment that requires further research.

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