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
