Intracameral Chemotherapy (Melphalan) for Aqueous Seeding in Retinoblastoma: Bicameral Injection Technique and Related Toxicity in a Pilot Case Study.

Details

Serval ID
serval:BIB_8A70623A76DB
Type
Article: article from journal or magazin.
Collection
Publications
Title
Intracameral Chemotherapy (Melphalan) for Aqueous Seeding in Retinoblastoma: Bicameral Injection Technique and Related Toxicity in a Pilot Case Study.
Journal
Ocular oncology and pathology
Author(s)
Munier F.L., Gaillard M.C., Decembrini S., Bongiovanni M., Beck-Popovic M.
ISSN
2296-4681 (Print)
ISSN-L
2296-4657
Publication state
Published
Issued date
07/2017
Peer-reviewed
Oui
Volume
3
Number
2
Pages
149-155
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The anterior chamber has been shown by pharmacokinetic studies to represent a sanctuary never achieving a tumoricidal dose with the present administration routes, such as systemic, intra-arterial, or intravitreal injections.
A novel intracameral chemotherapy technique is described to control aqueous seeding in a pilot unilateral group E retinoblastoma case with primary aqueous seeding. Anterior segment toxicity was carefully monitored.
Control of the retinal tumor and vitreous seeding was achieved by intra-arterial and intravitreal chemotherapies. Sterilization of the aqueous was achieved after a first cycle of 7 melphalan injections in the anterior chamber, but relapse was noted 3.5 months later. This relapse was finally controlled with a second cycle of 6 intracameral injections targeting the posterior chamber. Corneal endothelial cell density remained stable over the injection period. Heterochromia and a progressive cataract developed, which required cataract surgery. At 5 years' follow-up, the patient is tumor free with normal vision (20/20 in both eyes), full binocularity, and no metastasis.
The present bicameral injection technique appears to be safe and effective with limited toxicity. Melphalan-induced side effects were noted on the iris and lens but with no impact on the final visual function.

Keywords
Anterior chamber fluid, Aqueous seeding, Chemotherapy, Intracameral chemotherapy, Intravitreal injection, Melphalan, Pathology of the anterior segment, Retinoblastoma
Pubmed
Web of science
Open Access
Yes
Create date
22/05/2017 11:05
Last modification date
08/05/2019 21:39
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