手術用顕微鏡を用いた網膜芽細胞腫のレーザー光化学療法

Photoradiation treatment of retinoblastoma with argon laser and operating microscope

　放射線療法または光凝固療法で治癒しなかった網膜芽細胞腫患児5例にhematoporphyrin誘導体を投与後レーザー照射する光化学療法を行い，その効果を検討した．照射には手術用顕微鏡式アルゴンレーザー光凝固装置を用いた．5例中1例では，他の部位に腫瘍が再発したため眼球摘出したが残りの4例は治癒した．本法は他の治療法で治癒しなかった網膜芽細胞腫にも有効で，今後期待の持てる治療法である．また手術用顕微鏡を用いる方法は安定した照射ができる良い方法であると思われた．

We treated five cases of retinoblastoma by photoradiation using hematoporphyrin derivative and argon laser. All the cases proved to be resistant to prior photocoagulation or radiation therapy.

The patient received hematoporphyrin derivative at the dosis of 2.5 mg/kg intravenously. The tumor was treated, 72 hours later, by argon laser irradiation as applied over the whole tumor area. As the treatment had to be done under general anesthesia, the argon laser was mounted on an operating microscope.

In 4 out of the 5 cases, the tumor was brought to cure.Enucleation was necessary in the fifth case because of generalized dissemination of the tumor.Photoradiation treatment proves to be of value for retinoblastoma cases which failed to respond to other types of therapy. Use of operating microscope facili-tates laser application under general anesthesia.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(2) : 155-159, 1987