Транспупиллярная лазерная термотерапия: эффективность в лечении кавитарной ретинобластомы

Abstract

Purpose. To evaluate the efficacy of transpupillary thermotherapy (TTT) in the treatment of cavitary retinoblastoma (Rb). Material and methods. In the period from 2014 to 2018, 15 children (16 eyes, 21 tumors) with Rb were treated by pigment inducing TTT. The average age at the time of treatment was 22.8 months. The binocular form of Rb was observed in 9 patients (60%), monocular – in 6 (40%). In 5 cases (33%) TTT was performed in monocular patients. In total, 21 tumors of post-equatorial localization of Rb were treated by pigment inducing TTT, 12 of which (57%) were located in functionally significant areas of the fundus. The mean tumor height was 2.8 mm, the mean basal diameter was 6.5 mm. TTT was performed using a diode laser with the following parameters: wavelength – 810 nm, spot diameter – 1200 microns, power from 300 to 800 MW, with continuous exposure until the whitening of the tumor appearance. Results. Local tumor control after organ-preserving treatment was achieved in 95% of the cases (20 tumors). Complete tumor regression after pigment inducing TTT was achieved in 81% of cases (17 tumors). In 9% of the cases (2 tumors), partial regression of the tumor with stabilization was achieved. In one case (5%), brachytherapy was performed due to the continued tumor growth. 14 eyes (88%) were preserved after organ-preserving treatment. 2 eyes (12%) were enucleated due to tumor progression. Complications after pigment inducing TTT were observed in one case (6%) and were represented by partial vitreous hemorrhage. The mean follow-up period after pigment inducing TTT was 35 months. Conclusion. Pigment inducing TTT is highly effective in the treatment of cavitary Rb. Key words: ophthalmology, retinoblastoma, transpupillary thermotherapy, cavitary retinoblastoma, laser treatment, pediatric oncology.