[Effectiveness of transpupillary thermotherapy in addition to combination chemotherapy for retinoblastoma].

Abstract

Destruction of tumor foci in retinoblastoma (RB) is performed using both chemotherapeutic and local treatment methods. The number of published works devoted to the use of transpupillary thermotherapy (TTT) of small RBs in combined systemic and local chemotherapy is very limited, which determined the relevance of this study.

Purpose: This study analyzed the outcomes of using TTT as an addition to combination chemotherapy in children with small RBs.

Material and methods: The study included 42 patients (144 tumor foci) with small RBs treated between 2015 and 2020 using TTT and combination chemotherapy (systemic chemotherapy with local chemotherapy). Patients were aged 1 to 26 months (mean age 9.1±7.4 months). The mean follow-up period was 61.2±4.3 months.

Results: Patients received 3-5 courses of systemic neoadjuvant polychemotherapy (NAPCT), superselective intra-arterial chemotherapy (SIAC), and intravitreal chemotherapy (IVC), which led to tumor size reduction. TTT was performed 3 to 16 months (mean 8.5±3.3 months) after initiation of chemotherapy. The number of coagulates in the treatment of resorbable tumors ranged from 5 to 16 (mean 10.5±3.5) and did not depend on the localization of small RBs. The diameter of coagulates ranged from 1000 to 2500 μm (mean 1600±600 μm). Addition of TTT to combination chemotherapy of small RBs resulted in partial tumor regression in 32.6% and complete tumor resorption in 68.1% of cases.

Conclusion: This study provides the first analysis of TTT outcomes in RB patients undergoing combined chemotherapy. TTT is a method of choice for the treatment of small RBs with height of ≤3.0 mm and any localization.