血卟啉激光光动力全眼球照射治疗视网膜母细胞瘤

A CLINICAL STUDY ON THE EFFECT OF PHOTODYNAMIC WHOLE EYEBALL IRRADIATION WITH HEMATOPORPHYRIN DERIVATIVES FOR RETINOBLASTOMA

应用血卟啉激光光动力全眼球照射治疗视网膜母细胞瘤14例,其中眼内期9例,青光眼期5例。所有病例治疗前后均做B超及前房液细胞学检查证实。方法:血卟啉光敏剂按2.5～5mg/kg体重静注,48～72h后用氩离子激光泵浦染料激光耦合光纤,以点状光斑进行全眼球扫描照射,功率密度240～340mW/cm^2,前后部各照射30min。结果:完全消退8例,玻璃体液细胞学检查,瘤细胞全部变性坏死。显效6例。随访2年～5年6个月,未见复发。

This paper presents the results of hematoporphyrin derivatives (HPD) photodynamic whole eyeball irradiation in 14 cases of retinoblastoma. 9 cases were in intraocular stage, and 5 cases in glaucoma stage. Pre-and post-treatment examinations for all the patients included B-scan echography and cytopathologic study of the aqeous. After HPD allergic test, the patients with negative reaction received an IV infusion of HPD in the dose of 2.5 to 5 mg/kg body weight. 48 to 72 hours later, the patients underwent whole eyeball photoradiation with argon pumped dye laser. The laser beam was projected into the retina and the sclera to cover the anterior and posterior part of the tumor. The power density was 240 to 340 mW/cm2. Exposure time was 30 minutes. The follow-up time was 2-51/2 years. Complete remission was achieved in 8 cases. The cytopathologic study of vitreous fluid showed degeneration and necrosis of all the tumor cells. Significant remission was found in the other 6 cases.