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首页> 外文期刊>Pediatric blood & cancer >Intra-arterial chemotherapy is more effective than sequential periocular and intravenous chemotherapy as salvage treatment for relapsed retinoblastoma
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Intra-arterial chemotherapy is more effective than sequential periocular and intravenous chemotherapy as salvage treatment for relapsed retinoblastoma

机译：动脉内化疗比复发性视网膜母细胞瘤的挽救性治疗比顺序性眼周和静脉内化疗更有效

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Background: Treatment of eyes with retinoblastoma failing systemic chemoreduction and external beam radiotherapy is seldom efficacious. This study compares the efficacy and toxicity of intra-arterial ophthalmic artery chemotherapy (IAO) to our historical cohort of sequential periocular and systemic chemotherapy in such patients. Patients and Methods: Eighteen eyes (15 consecutive patients) were retrospectively evaluated. Eight eyes received IAO for a median of four cycles (range: 2-9) including melphalan alone (n=3) or after topotecan and carboplatin (n=4) or topotecan and carboplatin without melphalan (n=1). Ten eyes received a median of two cycles (range: 1-3) of periocular topotecan (n=9) or carboplatin (n=1) followed by intravenous topotecan and cyclophosphamide in three patients if at least stable disease was achieved. Both groups were comparable for disease extension and prior therapy. Results: No extraocular dissemination or second malignancy occurred and all patients are alive. The probability of enucleation-free eye survival at 12 months was 0.87 (95% CI: 0.42-0.97) for the IAO group, compared to 0.1 (95% CI: 0.06-0.35) for the periocular group (P<0.01). Ocular toxicity was mild and similar in both groups (mostly mild orbital edema). Systemic toxicity was low for IAO and periocular injection, but children who received sequentially intravenous chemotherapy (n=12 cycles) had five episodes of grade 4 neutropenia, three of which resulted in hospitalizations. No case in the IAO group presented these complications. Conclusions: IAO is significantly superior to sequential periocular-intravenous topotecan-containing regimens in eyes with relapsed intraocular retinoblastoma with a more favorable toxicity profile. ? 2012 Wiley Periodicals, Inc.
机译：背景：视网膜母细胞瘤的全身化学还原失败和外照射治疗的眼睛很少有效。这项研究将动脉内眼动脉化疗（IAO）的疗效和毒性与我们在此类患者中进行顺序眼周和全身化疗的历史队列进行了比较。患者和方法：回顾性评估18眼（连续15例患者）。八只眼接受IAO的中位数为四个周期（范围：2-9），包括单独的美法仑（n = 3）或托泊替康和卡铂（n = 4）或不加美法仑的托泊替康和卡铂（n = 1）。如果至少达到稳定的疾病，则三名患者中的十只眼接受了两个周期（范围：1-3）的眼周拓扑替康（n = 9）或卡铂（n = 1）的中值，然后接受静脉内拓扑替康和环磷酰胺治疗。两组在疾病扩展和既往治疗方面均相当。结果：未发生眼外播散或第二次恶性肿瘤，所有患者均活着。 IAO组在12个月时无眼球摘除的存活率为0.87（95％CI：0.42-0.97），而眼周组为0.1（95％CI：0.06-0.35）（P <0.01）。两组的眼毒性均为轻度且相似（多数为轻度眼眶水肿）。 IAO和眼周注射的全身毒性较低，但是接受顺序静脉化疗（n = 12个周期）的儿童发生了5次4级中性粒细胞减少症，其中3次导致住院。 IAO组中没有病例出现这些并发症。结论：在复发性眼内视网膜母细胞瘤眼中，IAO明显优于序贯性眼周静脉含托泊替康方案，且毒性更佳。 ？ 2012 Wiley期刊公司

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