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Intraarterial and intravitreal chemotherapy in the combined treatment in children with group C and D intraocular retinoblastoma
Author(s) -
Saakyan S.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0669
Subject(s) - medicine , enucleation , retinoblastoma , chemotherapy , brachytherapy , surgery , ophthalmology , radiation therapy , biochemistry , chemistry , gene
Purpose To evaluate the outcomes of Rb with group «C» and «D» after the combined treatment. Methods 45 patients, 22 (49%) male and 23(51%) female were included in study, age ranging from 1 to 42 months (median −13.5 ± 10.4 months). Children with age under 1 year – 62%. All 45 children received systemic chemotherapy VEC from 3 to 6 courses (median – 5 courses). 4 children were undergone primary enucleation (group E). For the treatment of the eyes groups C and D Rb ( n = 49) local chemotherapy was added SIAC and/or IVCT on the average after the third course of VEC. Focal therapy was used if need to consolidate treatment (TTT and/or brachytherapy). IVCT was used in 32 patients for 34 eyes with vitreous disease with median number of courses 2 (1–6). SIAC was used in 41 patients for 45 eyes with retinal or subretinal disease with or without vitreous seeding with median number of courses 2 (1–3). Results In 27 of 49 eyes after systemic chemotherapy the significant resorbtion of the tumor foci were revealed using chemotherapy, the other 22 eyes underwent additional treatment – in group C (TTT‐4 eyes, brachytherapy – 5 eyes) and in group D (TTT – 6 eyes, brachytherapy ‐6eyes). The patients with Rb of groups «C» and «D» had disease free survival (DFS) of 56.1 ± 8.9% with a median period of follow‐up 26.9 ± 2.5 months. 44 of 45 patients with Rb of groups «C» and «D» are alive with no metastatic disease (median follow up of 20 months (range 3–43 months)). One of 45 patients died due to second malignant tumor – acute leukemia.14 of 15 eyes (93.3%) with group «C» and 31 of 34 eyes (91.2%) with group «D» were preserved by combined chemotherapy and focal therapy. Conclusions Combined chemotherapy (VEC + SIAC + IVCT) with focal therapy allowed saving the eyes that enucleated earlier.