Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma
Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma
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DOI：
10.1136/bjo.83.4.448
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发表时间：
1999-04-01
影响因子：
4.1
通讯作者：
Chan, CC
中科院分区：
文献类型：
--
作者：
de Smet, MD;Vancs, VS;Chan, CC
目的-为了开发和评估一种治疗眼内淋巴瘤的方案，通过玻璃体内注射甲氨蝶呤和thiotepa.Methods-A眼内非霍奇金淋巴瘤的放疗后复发的患者和反复全身化疗方案进行了反复玻璃体内注射甲氨蝶呤和thiotepa。通过细胞学、前房闪光测量、IL-10和IL-6水平密切监测患者。甲氨蝶呤药物清除率的研究进行了玻璃体样本之前，每次injecting.Results-Complete肿瘤清除率达到治疗的第三周。随着肿瘤从眼睛中清除，IL-10和IL-6水平迅速下降到几乎检测不到的水平。在同一时间内，耀斑测量值从500光子/秒下降到15光子/秒。甲氨蝶呤水平随时间的曲线图显示了一阶动力学速率的消除与有效的杀肿瘤的玻璃体内剂量持续5天后injection.Conclusion-Intravitreal化疗治疗复发性眼内淋巴瘤出现有效的延长局部缓解眼部疾病，即使在存在的积极增长的肿瘤。甲氨蝶呤的单次玻璃体内注射可导致比全身给药所达到的持续时间更长的延长的杀肿瘤浓度。
Aim-To develop and assess a protocol for the treatment of intraocular lymphoma by intravitreal injection of methotrexate and thiotepa.Methods-A patient with intraocular non-Hodgkin's lymphoma which recurred after radiotherapy and repeated systemic chemotherapeutic regimens underwent repeated intravitreal injections of methotrexate and thiotepa. The patient was closely monitored by cytology, anterior chamber flare measurements, IL-10 and IL-6 levels. Methotrexate drug clearance studies were performed on vitreous samples taken before each injection.Results-Complete tumour clearance was achieved by the third week of therapy. IL-10 and IL-6 levels quickly dropped to barely detectable levels as the tumour was cleared from the eye. Flare measurements decreased from 500 to 15 photons/s over the same time. A plot of the methotrexate levels over time revealed a first order kinetic rate of elimination with an effective tumoricidal intravitreal dose persisting for 5 days after injection.Conclusion-Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma appears effective in prolonging local remission of ocular disease even in the presence of an aggressively growing tumour. A single intravitreal injection of methotrexate can lead to a prolonged tumoricidal concentration lasting for a longer period than that achieved by systemic administration.