1 sri of pediatric oncology and hematology of n. n. blokhin 1 sri of pediatric oncology and...

1 SRI of pediatric oncology and hematology of N. N. Blokhin

Cancer Research Center RAMS, Moscow

2 SRI of clinical oncology of N. N. Blokhin Cancer Research

Center RAMS, Moscow

3 S.Fyodorov Eye Microsurgery Complex, Moscow 

Selective intra-arterial and intravitreal chemotherapy by

melphalan in organ-saving treatment for intraocular Rb in children

Tatiana Ushakova1, Igor Trofimov 2, Olga Gorovtzova 1, Boris Dolgushin 2, Andrey Yarovoy 3, Evgeniya Bulgakova 3, Olesya Golubeva 3, Olga Krivovyaz 3, Vladimir Polyakov 1.

Purpose

To evaluate the efficiency of local chemotherapy (LCT) for Rb using selective intraarterial (SIAC) and intravitreal (IVCT) chemotherapy by melphalan as alternative to the RT and enucleation.

MethodsFrom 02.2011 to 03.2013 16 pts (19 eyes) with Rb received LCT.

SIAC• Akihiro Kaneko and • Shigenobu SuzukiEye-Preservation Treatment of Retinoblastoma with Vitreous SeedingJpn. J. Clin. Oncol. (2003) 33 (12): 601-607 .

Methods The tumor incidence in 19 eyes was represented by the

following groups B (n=1), C (n=4), D (n=8), E (n=2) and intraocular relapse (n=4).

SIAC was performed in 14 eyes and it was combined with IVCT in 9 eyes. IVCT without SIAC was applied in 5 eyes. 28 SIAC and 25 IVCT were successful, an average of two procedures for eye.

LCT (n=28 SIAC and n=25 IVCT)

Eyes (n)

SIAC (+ IVCT) 14 (9)

IVCT 5

Methods

The treatment included LCT after 3 or 4 courses system chemotherapy (SCT) in I group (6 pts, 9 eyes) followed by brachytherapy in 3 eyes.

II group (3 pts, 3 eyes) received LCT without SCT.

The treatment included LCT in a complex with SCT in III group (7 pts, 7 eyes) followed by brachytherapy + cryotherapy, laser in 3 eyes.

Results and Conclusions

Thanks to the LCT in 15 pts (17 eyes), it was possible to rescue 10 of 17 eyes without RT. In addition, another two eyes were rescued after RT and second line of SCT.

One pt refused treatment. All pts are alive with a median period of follow-up of 14 mos.

LCT with focal consolidation has shown high effectiveness in combined organ-saving treatment of intraocular Rb without RT.

Longer follow-up data are necessary for reliable assessment of the effectiveness of LCT.

Patient Т

Before treatment

After 4 cycles of SCT

After 1 cycle SIAC

Thank you very much for your attention