EXPERIENCES WITH COMBINED TREATMENT (BRACHYTHERAPY AND CYTOSTATIC THERAPY) OF THE SECOND EYE OF PATIENTS SUFFERING FROM BILATERAL RETINOBLASTOMAS

97th DOG Annual Meeting 1999

K624
EXPERIENCES WITH COMBINED TREATMENT (BRACHYTHERAPY AND CYTOSTATIC THERAPY) OF THE SECOND EYE OF PATIENTS SUFFERING FROM BILATERAL RETINOBLASTOMAS

J. Damjanovich, A. Berta

Introduction: Between 1989 and 1998 the second eye of 11 patients with bilateral retinoblastoma were treated with Ruthenium 106 b-ray plaques following the enucleation of the first eye at our Department.

Patients and Methods: The age of the 7 boys and 4 girls was between 3 months and three years. Diagnosis was based on indirect opthalmoscopy, ultrasonography and CT-scan performed under general anesthesia. Intraoperative ultrasonography and diaphanoscopy were used to determine the localization of the tumors and ensure the proper place of the applicators. Most patients were irradiated with one plaque, in two case two, in another case three applicators were used at the same time. In three cases additional cryoapplication was used. Eight patients received systemic cytostatic therapy (OPEC).

Results: The mean follow up period was 45.5 ± 34 months. Ten of our patients are still alive without signs of metastases. Seven of them are having acceptable visual acuity (four of them 5/5). Flat scars developed in seven eyes and one has a well observable tumor regression. One child had a phthytical eye. Another totally blind eye had to be enucleated, owing to a new growing tumor and total blindness.

Conclusion: The ideal treatment of bilateral retinoblastomas is still debated. Brachytherapy combined with cytostatic therapy may be an alternative to external beam irradiation of the second eye, especially if the latter is not available.

Dept. Ophthalmol. Medical University, 4012 Debrecen, Hungary

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