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KMID : 1130320130560060254
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Korean Journal of Pediatrics
2013 Volume.56 No. 6 p.254 ~ p.259
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Combined chemotherapy and intra-arterial chemotherapy of retinoblastoma
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Choi Sae-Rom
Han Jung-Woo
Kim Hyo-Sun
Kim Beom-Sik
Kim Dong-Joon
Lee Sung-Chul
Lyu Chuhl-Joo
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Abstract
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Purpose: Retinoblastoma (RB) is the most common primary malignant intraocular tumor in children. Although systemic chemotherapy has been the primary treatment, intra-arterial chemotherapy (IAC) represents a new treatment option. Here, we performed alternate systemic chemotherapy and IAC and retrospectively reviewed the efficacy and safety of this approach.
Methods: Patients diagnosed with intraocular RB between January 2000 and December 2011 at Severance Children’s Hospital, Yonsei University, were reviewed. Before February 2010, the primary treatment for RB was chemotherapy (non-IAC/CTX). Since February 2010, the primary treatment for RB has been IAC (IAC/CTX). External beam radiotherapy or high-dose chemotherapy (HDCTX) were used as “last resort” treatments just prior to enucleation at the time of progression or recurrence during primary treatment. Enucleation-free survival (EFS) and progression-free survival were assessed.
Results: We examined 19 patients (median age, 11.9 months; range, 1.4 to 75.6 months) with a sum of 25 eyes, of which, 60.0% were at advanced Reese Ellsworth (RE) stages. The enucleation rate was 33.3% at early RE stages and 81.8% at advanced RE stages (P =0.028). At 36 months, EFS was significantly higher in the IAC/CTX group than in the non-IAC/CTX group (100.0% vs. 40.0%, P=0.016). All 5 patients treated with IAC achieved eye preservation, although most patients were at advanced RE stages (IV-V).
Conclusion: Despite the limitation of a small sample size, our work shows that an alternative combined approach using IAC and CTX may be safe and effective for eye preservation in advanced RB.
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KEYWORD
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Retinoblastoma, Combination chemotherapy, Intra-arterial infusion, Eye enucleation
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