视网膜母细胞瘤经眼动脉灌注化学药物治疗研究进展

The progress of intra-arteriai chemotherapy for retinoblastoma

经眼动脉灌注化学药物治疗（IAC）是一种通过微导管将化学治疗药物精准注入眼动脉治疗视网膜母细胞瘤（RB）的介入放射治疗方法。与全身化学药物治疗相比，IAC能够显著提高晚期和复发性RB的保眼率，同时未发现严重不良反应。但由于IAC全身药物剂量较低，不能有效杀灭肿瘤细胞，所以对潜在的眼外肿瘤细胞不能有效控制。骨髓抑制是其主要的全身并发症，表现为一种或多种血细胞减少。局部并发症包括眼周皮肤红肿、多泪、上睑下垂、眼底出血或眼部血管栓塞等。尽管近10年临床应用探索已使IAC成为RB保眼治疗的一线方法之一，但目前仍缺乏相关安全性、有效性的随机对照多中心研究以及长期随访观察结果。

Intra-arterial chemotherapy （IAC） is an interventional treatment for retinoblastoma （RB） which infuses the chemotherapeutic agents through ophthalmic artery using microcatheters to control the tumor. Compared with systemic chemotherapy, IAC could significantly increase the globe salvage of advanced and recurrent RB without serious adverse event. Due to the absence of systemic absorption after IAC, no longer effectively kill tumor cell, which have potential danger to leads to inadequate elimination extraocular tumor cells. The most common systemic complications following IAC is myelosuppression;local ocular toxicities include eyelid edema, delacrimation, blepharoptosis, vitreous hemorrhage, retinal artery obstruction. During the last 10 years of clinical application, IAC become one of first-line treatment for intraocular RB. However, at present, there is still a lack of randomized controlled multicenter studies and long-term follow up of IAC.