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May 21-25, 2018 in Almaty, on the basis of the Republic of Kazakhstan Ministry of Health Scientific Center of Pediatrics and Pediatric Surgery, a master class is held with the participation of foreign specialists from Russia on the subject: "Surgical treatment of patients with retinoblastoma", dedicated to the organ-preserving treatment of malignant intraocular neoplasms-retinoblastoma. Within the framework of the master class, selective intra-arterial chemotherapy (SIAPT) was performed for the first time in the country for children with retinoblastoma and four children were operated.

To perform the operation, the roentgen surgeon Igor Trofimov and his anesthetist colleague Leonid Martynov were invited from the Moscow National Medical Research Center of Oncology named after N. Blokhin. The operation was carried out by Russian doctors jointly with oncologists, ophthalmologists, anaesthesiologists of the Pediatric Center and with an ophthalmologist from the Kazakh Scientific Research Institute (KazSRI) of eye diseases.

This was stated by the Director of the Scientific Center of Pediatrics and Pediatric Surgery of the Ministry of Health of the Republic of Kazakhstan, Ph.D. Riza Boranbayeva said in the framework of the press conference, devoted to the unique operation: "In the Republic of Kazakhstan since 2015, all children with an identified retinoblastoma are getting treatment at the Scientific Center of Pediatrics and Pediatric Surgery of the Ministry of Health of the Republic of Kazakhstan. Retinoblastoma is a malignant retinal tumor, the most frequent intraocular tumor of childhood. Annually in the Republic of Kazakhstan, from 20 to 25 primary patients per year are registered, mainly children under 5 years old. The incidence of this disease is 1 case per 14 000 - 20 000 live births and 4% of all malignant neoplasms in children. In recent years, the introduction of new technologies for treatment and diagnosis in oncology increases the life expectancy of children. Our specialists have undergone training in the leading center of Europe for retinoblastoma: University clinic Essen, which is the reference center of Germany and Austria, and also various master classes with the participation of foreign specialists are held on the basis of our center. Since 2015, local methods of therapy, such as laser coagulation and intravitreal chemotherapy, have been actively introduced and are being used in the center. In addition, the assessment of histological risk factors according to the international classification of the International Retinoblastoma Staging System (IRSS) is conducted from 2015, which allows for risk-adjusted therapy to reduce the development of late complications, such as secondary tumors. Since 2017, the application of orbital implants has begun after enucleation of the eyeball, which allows to reduce the cosmetic defect in the growing facial skeleton in children. The next challenge that faced us was the introduction of an advanced method of organ-preserving therapy that over the last 10 years of use in the US has allowed us to save not only the lives of children, but also to preserve up to 95% of the eyes. "

According to her, there are all conditions in the center of operation - special medical equipment and apparatus, and there are specialists.

- "Conducting this master class with the participation of foreign specialists from the Russian oncological centre of science (ROSC) named after Blokhin will allow to introduce a new selective intra-arterial chemotherapy technology for the first time, not only in Kazakhstan, but also in Central Asia. The introduction of this operation on the basis of our center will allow dozens of patients with retinoblastoma, who previously needed foreign treatment to undergo treatment in domestic clinics, " noted R. Boranbaeva.

The Kazakh Research Institute of Eye Diseases initiated the introduction of this technology in the Republic of Kazakhstan, its introduction into the guaranteed volume of free medical care, prepared for revision the Clinical Protocol "Retinoblastoma in Children", where the method of SIACT (Selective Intraarterial Chemotherapy) and other organ-preserving treatment methods was introduced. After approval by the Ministry of Health of the RK, the method of the SIACT will be implemented in the practice of the Scientific Center of Pediatrics and Pediatric Surgery of the Ministry of Health, where the children's oncology service and intervention surgery are consolidated and where all children with retinoblastoma undergo primary treatment.

"Organosecretary methods for the treatment of retinoblastoma are selective intra-arthral chemotherapy (SIACT), brachytherapy with ophthalmic applicators, cryodestruction, transpupillary thermotherapy and intravitreal chemotherapy with melphalan and topotecan. Of these, selective intra-arterial chemotherapy is the most effective. This treatment in America is used for more than 10 years. This method showed high efficiency and the survival rate of children was 100%. In Kazakhstan, the standard of treatment for this disease is eye removal (enucleation) followed by systemic polychemotherapy. Absence of an eye and lifelong artificial limb possessing causes serious psychological discomfort in patients and social disadaptation, especially in children and persons of working age. In this regard, treatment and rehabilitation of patients with this pathology is not only a medical, but also a significant social problem. Parents of children with retinoblastoma, seeking to save their eyes, go to foreign treatment, spending their own money. For example, treatment in Russia is 350,000 Russian rubles, in Switzerland, patients spend 60,000-70,000 US dollars. Over the past 10 years, the world has dramatically changed the algorithm for the treatment of retinoblastoma. Since 2015, the Kazakh Research Institute of Eye Diseases in conjunction jointly with SCPPS (Scientific Center of Pediatrics and Pediatric Surgery) began organosohranernoe treatment of retinoblastoma. The introduction and development of organ-preserving methods for the treatment of retinoblastoma will allow citizens of Kazakhstan to get free, highly specialized assistance, while preserving their eyes as anatomical and functional organ, "said President of the Board of JSC (Joint-stock company)" Kazakh Scientific Research Institute (KazSRI) "Marat Suleimenov.

Retinoblastoma is 90% among intraocular neoplasms in children and is characterized by high malignancy. Annually 8100 new cases of retinoblastoma are diagnosed in the world, 570-810 of them are in newborns. Retinoblastoma is characterized by an aggressive course with the filling of the entire eyeball with a tumor tissue, sprouting into the optic nerve, orbit, and the brain. A tumor is a threat not only in the form of loss of sight, but also in the form of high mortality due to metastasis and the development of second malignant neoplasms in other organs.

According to the Moscow doctor Igor Trofimov, the National Medical Research Center for Oncology named after. N.N. Blokhin treatment of eye cancer has been conducted since 2011.

- "The Blokhin Cancer Center is the only clinic in Russia dealing with the treatment of retinoblastoma. Over the past 5 years, these operations have been growing. Now in a year more than 120 operations are done in the center. The preparation and carrying out of the operation is spent1-1,5 with a half of hours. The preparation is targeted specifically in the center of the disease without damage to other organs, "- said the Russian vascular surgeon I. Trofimov.

During the press conference, the speakers thanked the Ministry of Health of the Republic of Kazakhstan for hosting the master class and thanked Charitable Foundation "Askar Zhakulin" for the providing sponsorship.

In the Republic, the introduction of new technologies for the treatment of tumors inside the eye at the Scientific Center for Pediatrics and Pediatric Surgery will be the greatest achievement not only in pediatrics, but also in the history of Kazakh medicine.

In the master class more than 30 oncologists, pediatricians and ophthalmologists from all regions of the Republic of Kazakhstan take part as listeners.