RESULTS OF LOCAL TREATMENT OF RETINOBLASTOMA AFTER POLYCHEMOTHERAPY

Purpose. To evaluate the results of the local treatment in cases of insufficient efficacy of retinoblastoma response to chemotherapy (CT).Material and methods. The study included 35 children (43 eyes) with insufficient response to the systemic and local CT which have a local impact (brachytherapy, cryosurgery, transpupillary diode-laser thermotherapy) on 101 retinoblastoma foci. Bilateral retinoblastoma was observed in 26 children, 16 children were monocular. Eight eyes were the group A, 12 – the group B, 13 – the group C, 10 – the group D. Forty five tumors were treated using the brachytherapy (Ru-106, Sr-90). In 7 eyes the plaques were relocated successively to irradiate two or three tumors. The transpupillary thermotherapy was performed in 32 tumors, the cryotherapy – in 24 foci. The follow-up was from 9 to 66 months (mean 19 months).Results. Forty one eyes (95%) were retained. The regression pattern types after each of the treatment methods are evaluated. A complete or partial regression was achieved in 43 tumors (96%) after the brachytherapy, in 28 tumors (88%) after the thermotherapy, in 23 tumors (96%) after the cryotherapy. The BT outcomes according to the apical dose varied from 53Gy to 85.8Gy). After the thermotherapy 4 recurrences (13%) were noted, after the cryotherapy – 1 (4%). There were no cases of metastases.Conclusion. The obtained results indicate the important role of the local methods in the system of organ-saving treatment of patients with retinoblastoma especially in case of exhausted reserves of chemotherapy.