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http://doi.org/10.31288/oftalmolzh201123844

COMBINED (INTRAVITREAL AND INTRAVENOUS) POLYCHEMOTHERAPY IN THE SYSTEM OF ORGAN-PRESERVING TREATMENT OF RETINOBLASTOMA

Bobrova N. F., Sorochinskaya T. A.

Odessa, Ukraine

There was devised a new technique of combined polychemotherapy by intravitreal injections of Melfalan (Alkeran) in combination with intravenous chemoreduction (VEC-protocol) in the system of organ-preserving treatment of retinoblastoma.

Combined polychemotherapy (PCT) was given to 29 children (35 eyes) aged from 3 months to 6 years (average 24±11 mon.) with T1-T3b stages of retinoblastoma and consisted in combination of the local chemotherapy - intravitreal introduction of 0.01 mg of cytostatic Melfalan (Alkeran) and systemic PCT - chemoreduction by VEC-protocol (Patent of Ukraine A61F 9/007 of 27/12/2010). The number of the intravitreal injections in one eye made up 1—4, the number of chemoreduction courses was 3—4. The long-term results from 3 to 14 months (on an average 6.3 + 1.2 mon) were followed-up in 15 children (19 eyes).

There were no complications in introduction of the preparation and in the postoperative period. In 5—6 weeks regressive changes were revealed in 93.7 % of the eyes: consolidation, defragmention, calcification of big tumerous foci with reduction in their size and prominence, resorption or atrophy of fine foci in the retina and clones in the vitreous body.

In 14 eyes at the stage of T1-T3a there was considerable improvement in the condition or complete regression of the tumor in the long-term period.

Combination of intravitreal injections of Melfalan (Alkeran) and intravenous chemoreduction is a new effective and safe method in the system of organ-preserving treatment of retinoblastoma, especially as a primary therapy and in presence of piercing of the tumor and its clones into the vitreous body.

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