Intra-arterial Chemotherapy as Primary Treatment for Cavitary Retinoblastoma: Excellent Response in Eight Tumors.
Intra-arterial Chemotherapy as Primary Treatment for Cavitary Retinoblastoma: Excellent Response in Eight Tumors.
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DOI：
10.1016/j.oret.2020.08.011
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Daniels AB
中科院分区：
文献类型：
--
作者：
Zheng Y;Froehler MT;Friedman DL;Daniels AB
“腔型”视网膜母细胞瘤历来表现出静脉化疗减少的最小治疗反应，表现出较弱的消退和较小的肿瘤大小缩小。据报道，动脉内化疗（IAC）可以更有效地治疗视网膜母细胞瘤，使许多以前无法挽救的眼睛现在得以挽救。目的是报道腹腔视网膜母细胞瘤对IAC的治疗反应。回顾性病例系列：腹腔视网膜母细胞瘤患者经IAC治疗。2015年8月至2019年1月期间接受原发性IAC治疗的所有腔型视网膜母细胞瘤患者的回顾性病例系列。肿瘤消退、复发、玻璃体和视网膜下种子消退、需要的治疗次数、球体挽救、转移和死亡。应用IAC治疗4例6眼8例腔性视网膜母细胞瘤。腔内肿瘤100%消退（8/8个肿瘤，6/6眼），玻璃体和视网膜下种子100%消退，眼球100%保留。没有肿瘤复发，没有患者发生转移，也没有患者死亡。眼睛的IAC治疗中位数为4.5个周期（范围1-7），晚期患者使用的IAC治疗较少（最近3只眼睛每只眼睛治疗1-3次，而最早3只眼睛每只眼睛治疗6-7次）。厚度平均减少73.4%（范围59.7-84.6%）。基底直径平均减少45.5%（范围：24.8-56.0%）。IAC治疗导致腔隙性视网膜母细胞瘤的消退，通常比静脉化疗更能缩小肿瘤大小。采用前期三联治疗（如美法兰[0.4mg/kg]、卡铂[50mg]和拓扑替康[2mg]），并注意某些早期消退的细微迹象，有助于减少不必要的额外治疗周期。从历史上看，静脉化疗对腔体视网膜母细胞瘤的影响很小。我们报告动脉内化疗具有良好的肿瘤控制（8/8）和球体挽救（6/6）。许多眼睛的尺寸比静脉化疗的典型报告缩小得更大。
The “cavitary” form of retinoblastoma has historically demonstrated minimal treatment response with intravenous chemoreduction, showing less robust regression and less reductions in tumor size. Intra-arterial chemotherapy (IAC) has been reported to more effectively treat retinoblastoma, allowing many previously-unsalvageable eyes to now be saved. The purpose was to report treatment response of cavitary retinoblastoma tumors to IAC. Retrospective case series Patients presenting with cavitary retinoblastoma who were treated with IAC. Retrospective case series of all patients presenting with cavitary retinoblastoma between August 2015 and January 2019 who were treated with primary IAC. Tumor regression, recurrence, resolution of vitreous and subretinal seeds, number of treatments required, globe salvage, metastasis, and death. Eight cavitary retinoblastoma tumors in 6 eyes of 4 patients were treated with IAC. One hundred percent of the cavitary tumors regressed (8/8 tumors, in 6/6 eyes), 100% of vitreous and subretinal seeds regressed, with 100% globe salvage. None of the tumors recurred, no patients developed metastases, and no patients died. Eyes were treated with a median of 4.5 cycles of IAC (range 1–7), with fewer IAC treatments used in the later patients (1–3 treatments per eye for the most recent 3 eyes, compared to 6–7 treatments per eye for the earliest 3 eyes). Mean reduction in thickness was 73.4% (range: 59.7–84.6%). Mean reduction in basal diameter was 45.5% (range: 24.8–56.0%). Treatment with IAC results in regression of cavitary retinoblastoma, often with greater reduction in tumor size than has been reported previously with intravenous chemotherapy. Using upfront triple therapy (such as melphalan [0.4mg/kg], carboplatin [50mg], and topotecan [2mg]) and noting certain subtle signs of early regression can help to minimize unnecessary additional cycles of treatment. Historically, cavitary retinoblastoma showed minimal regression with intravenous chemotherapy. We report excellent tumor control (8/8) and globe salvage (6/6) with intra-arterial chemotherapy. Many eyes showed greater reduction in size than typically reported for intravenous chemotherapy.
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影响因子：
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