视网膜母细胞瘤的化学减容治疗

Chemoreduction treatment in retinoblastoma

目的评价化学减容作为视网膜母细胞瘤辅助治疗的有效性。方法回顾性分析23例(28眼41个瘤体)视网膜母细胞瘤患者用长春新碱、鬼臼乙叉甙和卡铂治疗6个疗程,间隔3周,根据肿瘤情况,再决定其他局部治疗。结果在化学减容治疗前检查,肿瘤平均基底为12.46mm,高度为8.6mm;继发性视网膜脱离有22眼。化学减容治疗6个疗程后,所有41个肿瘤瘤体缩小,均显示明显钙化斑;肿瘤基底平均6.85mm,高度3.72mm,分别减少43.6%、56.7%;视网膜下液完全吸收,视网膜平复20眼。化学减容治疗引发的全身毒性反应较少,其他局部治疗得以实行。结论化学减容可使肿瘤减小,可联合冷冻、光凝、温热疗法或巩膜敷贴器等治疗,从而减少眼球摘除和外放射治疗。

Objective To evaluate the efficacy of chemoreduetion in the neoadjuvant of rettnoblastoma. Methods A retrospective pilot study was performed to assess the effectiveness of 6 cyclial ehemoreduction regimen of vineristtne sulfate,etoposide and carboplatin in patients with retinoblastoma.The study included 23 patients with 41 tumors in 28 eyes. Results At the initial examination , the mean tumor base was 12.46 man and the thickness was 8.6 mm. The secondum retinal detachment was present in 22 eyes. After 6 cycltal chemoreduction treatment, all tumors showed regression in size and visible evidence of calcification,the mean tumor base was 6.85 mm and the thickness was 3.72 mm. Overall, there was a mean 43.6% decrease in base and 56.7% decrease in thickness of the tumor at the end of the treatment period. The subretinal fluid was resolved completely, leaving flat retina in 20 eyes. Short-term systemic toxic effects were mild. Other local treatments could be made after ehemoreduction. Conclusion Chemoreduction treatme-nt can lead to tumor shrinkage and be combined with other invasive treatments, such as cryotherapy, laser photocoagulation , thermotherapy, or plaque radiotherapy,which avoid the eyeball enucleation and external radiotherapy. [ Rec Adv Ophthalmol 2007 ;27 （2） ：135-137 ]