Periocular Topotecan for Intraocular Retinoblastoma
Periocular Topotecan for Intraocular Retinoblastoma
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DOI：
10.1001/archophthalmol.2011.130
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发表时间：
2011-06-01
影响因子：
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通讯作者：
Gallie, Brenda L.
中科院分区：
文献类型：
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作者：
Mallipatna, Ashwin C.;Dimaras, Helen;Gallie, Brenda L.
目的：回顾性分析盐酸托泊替康眼周纤维蛋白封闭剂（Tisseel）治疗眼内视网膜母细胞瘤的有效性和毒性。方法：回顾性分析眼周托泊替康治疗视力威胁或复发性眼内视网膜母细胞瘤的病历。结果：8名儿童（10只眼）接受了1至4次眼周拓扑替康纤维蛋白封闭剂注射，没有或伴随激光和/或单次冻融化疗前冷冻疗法。中位剂量为0.18 mg/kg（3.72 mg/m2）。对治疗有反应的6名儿童患有小的离散肿瘤（8只国际眼内视网膜母细胞瘤分类A组或B组眼睛）。其中，3名儿童（3只眼）的既往主要治疗为激光; 1名儿童（2只眼）接受了局部激光全身化疗; 2名儿童（3只眼）接受了眼周拓扑替康治疗。在4名儿童（4只眼）中，肿瘤消退足以进行有效的局部治疗，但在2名儿童（4只眼）中，长期控制需要全身化疗。2例未缓解的儿童均为国际眼内视网膜母细胞瘤分类D组，主要接受全身化疗、局部激光和冷冻治疗，复发性疾病未被眼周拓扑替康控制;双眼最终均被摘除。未观察到眼部和极轻微的血液学毒性作用。在11个月的中位随访后拓扑替康治疗（18个月，自诊断），所有8组A和B的眼睛被保留与正在进行的焦点治疗需要在只有1组B眼; 2组D眼enoclate.Conclusion：眼周拓扑替康纤维蛋白密封剂可以实现体积减少小，复发性视网膜母细胞瘤足以让成功的焦点治疗。
Objective: To review the effectiveness and toxicity of periocular topotecan hydrochloride in fibrin sealant (Tisseel) for the control of intraocular retinoblastoma.Methods: Retrospective medical record review of visually threatening or recurrent intraocular retinoblastoma treated with periocular topotecan.Results: Eight children (10 eyes) received 1 to 4 injections of periocular topotecan in fibrin sealant, without or with concomitant laser and/or single freeze-thaw pre-chemotherapy cryotherapy. Median dose was 0.18 mg/kg (3.72 mg/m(2)). The 6 children who responded to treatment had small discrete tumors (8 International Intraocular Retinoblastoma Classification group A or B eyes). Of these, prior primary treatment for 3 children (3 eyes) was laser; for 1 child (2 eyes), systemic chemotherapy with focal laser; and for 2 children (3 eyes), periocular topotecan. In 4 children (4 eyes), tumor regression was sufficient for effective focal therapy, but in 2 children (4 eyes), long-term control required systemic chemotherapy. The 2 children who did not respond each had an International Intraocular Retinoblastoma Classification group D eye treated primarily with systemic chemotherapy, focal laser, and cryotherapy and recurrent disease that was not controlled by periocular topotecan; both eyes were eventually enucleated. No ocular and minimal hematological toxic effects were observed. At 11 months' median follow-up after topotecan treatment (18 months since diagnosis), all 8 group A and B eyes were retained with ongoing focal therapy required in only 1 group B eye; the 2 group D eyes were enucleated.Conclusion: Periocular topotecan in fibrin sealant can achieve volume reduction of small and recurrent retinoblastoma sufficient to allow successful focal therapy.