摘要
目的观察视网膜母细胞瘤（RB）患者全身化学药物治疗联合局部治疗的临床效果。方法回顾分析2006年8月至2007年9月本院收治的68例84只眼行全身化疗联合局部治疗并随访3个月以上的RB患儿的临床资料。所有患儿均进行眼部超声（B型超声或彩色多普勒超声）、影像学（cT／MRI）以及眼底照相检查（RetCam婴幼儿眼底照相机），确诊为RB的患儿共66例82只眼，双眼16例，单眼50例；男性36例，女性30例。按照国际眼内视网膜母细胞瘤分期（IIRC）系统分期，A期选择局部治疗（包括激光光凝和冷冻疗法），B、C、D、E期在系统化疗（CCTV方案，环孢霉素、卡铂、替尼泊苷、长春新碱）的基础上，联合手术（包括局部治疗、眼球摘除和眶内容剜出）治疗。随访时间6～13个月，平均8．6个月。结果按IIRC分期，A期5只眼，B期6只眼，C期5只眼，D期15只眼，E期51只眼（包括球外转移的）；治疗结束后22只眼得以保存，其中，A～E期分别为5、6、5、4、2只眼，分别占同期治疗眼的100％、100％、100％、26．7％、3．9％；死亡5例，均为E期患者，占总人数的7．6％。结论眼科手术或联合系统化学治疗RB是有效的，其疗效与患者肿瘤的临床分期有关，A、B、C期患者治疗效果较好，D、E期次之。
Objective A short-term observation study of ocular surgery with or without systemic chemotherapy to treat retinoblastoma （RB）. Method The clinical data of 66 RB cases treated at Beijing Tongren Hospital from August 2006 to September 2007 were retrospective reviewed. All patients received ultrasound （B scan/CDI）, radiology examination （CT scan/MRI） and RetCam retina examination, and classified according to the International Intraocular Retinoblastoma Classification （IIRC） method. Focal therapies （include laser and eryotherapy） were applied to Group A, systemic chemotherapy （CCTV protocol, Cyclosporine, Carboplatin, Teneposide and Vinerinstine） plus ocular surgery （include focal therapy, enucleation and orbital exenteration） to Group B, C, D and E. Patients were followed-up for more than 6 months. Result Of 66 cases （36 male/30 female）, 16/66 cases were bilateral RB and 50/66 were unilateral. Follow up period was from 6 to 13 months （mean time 8.6 month）. According to IIRC, there were 5 eyes in Group A, 6 eyes in Group B, 5 eyes in Group C, 15 eyes in Group D and 51 eyes in Group E （ include extraocular disease）. 22/82 eyes were conserved at the end of follow up, including 5/5（100%） of group A, 6/6（100%） of group B, 5/5（100%） of Group C, 4/15（26.7%） of Group D and 2/51（3.9%） of Group E. 5/66 （7. 6%） patients died during this period, they all were in Group E. Conclusion Ocular surgery combined with systemic chemotherapy is an effective method to treat retinoblastoma. The consequences depends on the classification with higher conservative rate of eyeballs in early and middle stage （Oroup,A, B, C）, and lower rate in late stage （Group D and E）.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2009年第2期85-88,共4页
Chinese Journal of Ocular Fundus Diseases
