The technique of ophthalmic arterial infusion therapy for patients with intraocular retinoblastoma.
The technique of ophthalmic arterial infusion therapy for patients with intraocular retinoblastoma.
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DOI：
10.1007/s10147-004-0392-6
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发表时间：
2004-04-01
影响因子：
3.3
通讯作者：
Mohri, Makoto
中科院分区：
文献类型：
--
作者：
Yamane, Takashi;Kaneko, Akihiro;Mohri, Makoto
最近，人们越来越关注用全身化疗联合局部激光治疗和冷冻治疗代替放疗来治疗眼内视网膜母细胞瘤。我们开发了一种选择性眼动脉输注（SOAI）治疗系统，使用美法仑进行治疗，这种药物在克隆形成试验中对视网膜母细胞瘤效果最大。 SOAI 系统由微球、引导导管和冲洗接头组合而成。引导导管选择性插入颈内动脉颈段后，将微球推进至眼动脉口远端。在颈内动脉暂时闭塞期间，从引入的导管尖端注入马法兰。我们用 SOAI 治疗了 187 例眼内视网膜母细胞瘤患者；对 610 只眼睛进行了 563 次 SOAI。技术成功率为97.51%。十四次考试不及格。未检测到因导管插入术引起的明显并发症（包括脑梗塞）。 SOAI采用球囊封堵技术，安全性高，可避免全身化疗带来的副作用，无需放疗和剜除术。
Recently, there has been increasing interest in treating intraocular retinoblastoma with systemic chemotherapy combined with focal laser therapy and cryotherapy instead of radiotherapy. We developed a system of selective ophthalmic arterial infusion (SOAI) therapy, administering melphalan, the agent which had the greatest effect on retinoblastoma in a clonogenic assay. The SOAI system consists of a combination of a micro-balloon, a guiding catheter, and a flushing hub. After selective catheterization to the cervical segment of the internal carotid artery by the guiding catheter, the micro-balloon was propelled to the portion just distal to the orifice of the ophthalmic artery. During temporary occlusion of the internal carotid artery, melphalan was infused from the introduced catheter tip. We treated 187 patients with intraocular retinoblastoma with SOAI; 563 SOAIs were performed for 610 eyes. The technical success rate was 97.51%. Fourteen examinations failed. No significant complication due to catheterization (including brain infarction) was detected. SOAI, using the balloon occlusion technique, is safe, and its use will prevent the side effects that occur with systemic chemotherapy, and eliminate the need for irradiation and enucleation.