CAJ | 학술논문

视网膜母细胞瘤(RB)常伴有玻璃体腔种植.由于玻璃体内缺乏血液供应,化疗药物难以在玻璃体内达到有效浓度.尽管全身化疗及眼动脉介入化疗明显提高了RB的眼球保留率,但对于玻璃体腔内子瘤的控制仍不理想.近年来,玻璃体腔注药(IViT)治疗RB引起了很大的关注.玻璃体腔注射马法兰等抗肿瘤药物对于RB伴玻璃体腔种植具有良好的疗效,且副作用较小.掌握安全剂量以及优化操作技术流程,可以进一步降低并发症的风险.对于伴有顽固性或复发性玻璃体腔种植的RB患者,IViT提供了一个相对安全有效的保留眼球的途径,有望成为临床上治疗RB的一种重要手段.目前IViT的批准有待于二期临床试验的结果.本文就IViT治疗伴玻璃体腔种植RB的疗效、副作用以及如何提高治疗安全性等方面的研究进展进行综述.
시망막모세포류(RB)상반유파리체강충식.유우파리체내결핍혈액공응,화료약물난이재파리체내체도유효농도.진관전신화료급안동맥개입화료명현제고료RB적안구보류솔,단대우파리체강내자류적공제잉불이상.근년래,파리체강주약(IViT)치료RB인기료흔대적관주.파리체강주사마법란등항종류약물대우RB반파리체강충식구유량호적료효,차부작용교소.장악안전제량이급우화조작기술류정,가이진일보강저병발증적풍험.대우반유완고성혹복발성파리체강충식적RB환자,IViT제공료일개상대안전유효적보류안구적도경,유망성위림상상치료RB적일충중요수단.목전IViT적비준유대우이기림상시험적결과.본문취IViT치료반파리체강충식RB적료효、부작용이급여하제고치료안전성등방면적연구진전진행종술.
Vitreous seeding is common in retinoblastoma.As vitreous is lack of blood supply,chemotherapy drugs can hardly reach the effective concentration in the eye.Intravenous chemotherapy and ophthalmic arterial chemotherapy have improved the salvage of the globe in patients with retinoblastoma.However,persistent or recurrent viable vitreous seeds become one of the most challenging conditions for eyepreservation therapy.In recent years,intravitreal injection therapy (IViT) has attracted great attention.Intravitreal injection of melphalan or other anti-tumor drugs has demonstrated success in the treatment of vitreous seeds with less side effects.To further reduce the risk of intraocular toxicity,we should use drugs at safe doses and improve the injection technique.Although IViC appears to offer a comparatively safe and efficient salvage option to refractory and recurrent vitreous seeds,its validation awaits the results of a prospective phase Ⅱ clinical trial.In this review,we summarized the recent research progress in IViT for retinoblastoma with vitreous seeding in terms of its effectiveness,complications and safety improvement.