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

Détails

ID Serval
serval:BIB_8A70623A76DB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Intracameral Chemotherapy (Melphalan) for Aqueous Seeding in Retinoblastoma: Bicameral Injection Technique and Related Toxicity in a Pilot Case Study.
Périodique
Ocular oncology and pathology
Auteur(s)
Munier F.L., Gaillard M.C., Decembrini S., Bongiovanni M., Beck-Popovic M.
ISSN
2296-4681 (Print)
ISSN-L
2296-4657
Statut éditorial
Publié
Date de publication
07/2017
Peer-reviewed
Oui
Volume
3
Numéro
2
Pages
149-155
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.

Mots-clé
Anterior chamber fluid, Aqueous seeding, Chemotherapy, Intracameral chemotherapy, Intravitreal injection, Melphalan, Pathology of the anterior segment, Retinoblastoma
Pubmed
Web of science
Open Access
Oui
Création de la notice
22/05/2017 11:05
Dernière modification de la notice
08/05/2019 21:39
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