眼球温熱化学療法で治癒した，眼球内に再発した網膜芽細胞腫の2例

Chemo-thermotherapy was successful in two cases of recurrence of intraocular retinoblastoma after irradiation

　放射線外照射後に再発した眼球内網膜芽細胞腫を眼球温熱化学療法を使用して，有用な視力を維持して治癒した2症例を報告した。本治療法は患側内頚動脈からmelphalanを40 mg／m²注入し，引き続きLagendijkにより開発された眼球加温装置で45℃で1時間，眼球を加温する方法である。症例1は3乳頭径の腫瘍が黄斑部に再発したが，0.2の矯正視力を治療後3年維持している。症例2は硝子体播種と4乳頭径の腫瘍が黄斑近くに再発したが，0.9の矯正視力を治療後2年8か月維持している。一過性の骨髄抑制と脱毛が本治療の副作用である。白内障や角膜障害は治療後約3年間に，まったく発生していない。

We performed chemo-thermotherapy in 2 cases of recurred intraocular retinoblastoma. Both cases had been successfully treated with radiation 1 year before at the age of 1 year 5 months and 29 months before at the age of 3 years 7 months respectively. At the time of recurrence, the tumor was 3 discdiameters (DD) across and was located in the macular region in the first case. The tumor was 4 DD across and was associated with vitreous seeding in the second case.

During the actual procedure of chemo-thermotherapy, melphalan is injected, at the dosis of 40 mg/m², into the ipsilateral internal carotid. Consecutive hyperthermia of the eyeball at 45℃ for 1 hour is achieved with the use of Langendijk's applicator. One single treatment was followed by regression of the tumor with eventual cure. The patients maintain corrected visual acuity of 0.2 and 0.9 each approximately 3 years after the treatment. Temporary bone marrow suppression and hair loss were chief side effects of the therapy. Neither cataract nor keratopathy has been observed during the follow up period.