1 SRI of pediatric oncology and hematology of N. N. Blokhin 1 SRI of pediatric oncology and hematology of N. N. Blokhin Cancer Research Center RAMS, Moscow.

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Presentation transcript:

1 SRI of pediatric oncology and hematology of N. N. Blokhin 1 SRI of pediatric oncology and hematology of N. N. Blokhin Cancer Research Center RAMS, Moscow Cancer Research Center RAMS, Moscow 2 SRI of clinical oncology of N. N. Blokhin Cancer Research 2 SRI of clinical oncology of N. N. Blokhin Cancer Research Center RAMS, Moscow Center RAMS, Moscow 3 S.Fyodorov Eye Microsurgery Complex, Moscow 3 S.Fyodorov Eye Microsurgery Complex, Moscow Selective intra-arterial and intravitreal chemotherapy by melphalan in organ-saving treatment for intraocular Rb in children Tatiana Ushakova1, Igor Trofimov 2, Olga Gorovtzova 1, Boris Dolgushin 2, Andrey Yarovoy 3, Evgeniya Bulgakova 3, Olesya Golubeva 3, Olga Krivovyaz 3, Vladimir Polyakov 1.

Purpose To evaluate the efficiency of local chemotherapy (LCT) for Rb using selective intraarterial (SIAC) and intravitreal (IVCT) chemotherapy by melphalan as alternative to the RT and enucleation.

Methods From to pts (19 eyes) with Rb received LCT. SIAC Akihiro Kaneko and Shigenobu Suzuki Eye-Preservation Treatment of Retinoblastoma with Vitreous Seeding Jpn. J. Clin. Oncol. (2003) 33 (12):

Methods  The tumor incidence in 19 eyes was represented by the following groups B (n=1), C (n=4), D (n=8), E (n=2) and intraocular relapse (n=4).  SIAC was performed in 14 eyes and it was combined with IVCT in 9 eyes. IVCT without SIAC was applied in 5 eyes. 28 SIAC and 25 IVCT were successful, an average of two procedures for eye. LCT (n=28 SIAC and n=25 IVCT)Eyes (n) SIAC (+ IVCT) 14 (9) IVCT 5

Methods  The treatment included LCT after 3 or 4 courses system chemotherapy (SCT) in I group (6 pts, 9 eyes) followed by brachytherapy in 3 eyes.  II group (3 pts, 3 eyes) received LCT without SCT.  The treatment included LCT in a complex with SCT in III group (7 pts, 7 eyes) followed by brachytherapy + cryotherapy, laser in 3 eyes.

Results and Conclusions  Thanks to the LCT in 15 pts (17 eyes), it was possible to rescue 10 of 17 eyes without RT. In addition, another two eyes were rescued after RT and second line of SCT.  One pt refused treatment. All pts are alive with a median period of follow-up of 14 mos.  LCT with focal consolidation has shown high effectiveness in combined organ-saving treatment of intraocular Rb without RT.  Longer follow-up data are necessary for reliable assessment of the effectiveness of LCT.

Patient Т

After 4 cycles of SCT After 1 cycle SIAC

Thank you very much for your attention