IAC化疗方案对眼内视网膜母细胞瘤的临床疗效观察

Clinical Observation on IAC Chemotherapy for Intraocular Retinoblastoma

目的探讨经眼动脉灌注化学药物治疗(IAC)方案对眼内视网膜母细胞瘤(RB)的治疗疗效。方法回顾性选择2014年3月-2017年2月我院收治的64例眼内期RB患者,所有患者均接受IAC灌注化疗方案,统计并分析化疗后肿瘤的变化、复发及不良反应的发生情况。结果与治疗前相比,所有患者经IAC方案治疗后,肿瘤体积明显缩小,肿瘤高度明显降低(P<0.05)。64例患者治疗后均接受随访,其中4例在后期随访中失去联系,随访有效率93.75%。60例患者中有72只患眼化疗后近期疗效有所改善,其中52只患眼肿瘤体积缩小、钙化,症状得到明显缓解,缓解率72.22%,患者视力得到一定程度恢复。其中C期有1只患眼复发或出现新发病灶,复发率16.67%;D期有28只患眼复发或出现新发病灶,复发率60.87%。所有患者均全程接受IAC化疗方案,均未发生明显肾损伤和严重感染等不良反应,但均发生脱发现象,其中51例(79.69%)患者发生恶心、呕吐、厌食等轻度胃肠道反应,10例(15.63%)患者出现轻度肝损伤,经对症治疗后,症状均有所缓解;术后53例(82.81%)患者眼周出现红肿、多泪、结膜充血等,未进行特殊处理,一般可自行恢复。结论 IAC灌注化疗方案对眼内期RB患者有较好的临床疗效,不良反应较轻,患者易于接受,临床应用依从性好。

Objective To investigate the therapeutic effects of intra-arterial chemotherapy (IAC) regimen on intraocular retinoblastoma (RB).Methods A retrospective study was conducted on 64 patients with intraocular RB who received IAC treatment in our hospital between March 2014 and February 2017.All patients received IAC regimen,and the changes of tumors,recurrence and adverse reactions were analyzed.Results Compared with before treatment,the tumors of all patients were significantly reduced after IAC treatment (P<0.05),and the height of tumors was significantly reduced (P<0.05).Sixty-four patients were all followed up after treatment.Four of them could not be contacted during the late follow-up.The effective follow-up rate was 93.75%.Of the 60 patients,72 eyeballs had improvement in the near future after chemotherapy,and 52 of them had obviously relieved symptoms such as tumor shrinkage and calcification.The remission rate was 72.22%.The visual acuity of the patients was restored to a certain extent.Yet,one eye in stage C had recurrence or new lesions,and the recurrence rate was 16.67%.Twenty-eight eyes in stage D had recurrence or new lesions,and the recurrence rate was 60.87%.All patients received IAC chemotherapy throughout the course without obvious kidney injury or serious infection.However,all patients had hair loss;51 patients had mild gastrointestinal reactions such as nausea,vomiting and anorexia,with an incidence rate of 79.69%;10 patients had mild liver injury,and the incidence rate was 15.63%.After symptomatic treatment,all symptoms were alleviated.The incidence rate of adverse reactions like periocular swelling,tearing and conjunctival congestion was 82.81% after operation.And they all recovered without special treatment.Conclusion IAC infusion chemotherapy regimen has a good clinical effect on RB patients,with slight and tolerable adverse reactions.