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Analysis of Prognostic Factors of Comprehensive Treatment on Retinoblastoma |
Lu Lu,Song Tang,Hui Guo,Guiqin Liu,Dongsheng Zhao |
Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen 518040, China |
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Abstract Objective: To characterize the comprehensive treatment of retinoblastoma (RB) and investigate the related clinical factors. Methods: In this retrospective study, clinical datas were analyzed for 65 cases (92 eyes)of childhood RB that received comprehensive treatment, including chemotherapy, local treatment Oaser or
cryotherapy), and enucleation. Using t-test and Fisher's exact test to analyze the data. Results: The survival rate for the 65 cases was 92%. The eyeballs were preserved in 51% of the children. The rate of eyeball preservation in stage E group was significantly lower than the other four stage groups (P<O.OI). Children
in stage D group (18 cases) and stage E group (24 cases) were treated with chemotherapy combined with local therapy. The eyeballs were preserved in 11 cases in stage D groups and 4 cases in stage E groups.There were no significant differences in the clinical factors between eyeballs preserved or not children.
The patients in stage D and E groups were further divided into three groups according to the location of the tumors in the eye: it showed peripheral retina (including the mid- peripheral retina) group with higher rate of eyeball preservation than the posterior pole retina and the posterior pole retina+peripheral retina group(P=0.009, 0.021). Four of the 42 patients died, all with tumors located in the posterior pole retina (P=0.045 compared to the peripheral retina and to the posterior pole retina+peripheral retina). Conclusions: Compr-ehensive treatment improved the survival and eyeball preservation rate of children with RB. The survival
rates and eyeball preservation rates were closely related to the clinical stage.
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Received: 25 April 2017
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Fund: This study was funded by Shenzhen Science and Technology Innovation Committee Environment Construction Foundation (ZDSY20130402154836214), and Shenzhen Science and Technology Innovation Committee Key Research Program (CX22201 3051616181591) |
Corresponding Authors:
Song Tang, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology,Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen 518040,China (Email:ts0079@126.com)
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[1] |
Broaddus E, Topham A, Singh AD. Incidence of retinoblastoma in the USA: 1975-2004. Br J Ophthalmol, 2009, 93(1): 21-23.
|
|
DOI: 10.1136/bjo.2008 .13 8750.
|
[2] |
Yun J, Li Y, Xu CT, et al. Epidemiology and RBl gene of retinoblastoma. Int J Ophthalmol, 2011, 4(1): 103-109. DOI: 10.
|
39 |
80/j .issn.2222 -3959.2011 .01.24.
|
[3] |
Gallie BL, Zhao J. Vandezande K. et al. Global issues and opportunities for optimized retinoblastoma care. Pediatr Blood
|
|
Cancer, 2007, 49(7 Suppl.): 1083-1090. DOI: 10.1002/pbc.21350.
|
[4] |
Abramson DH. Shields CL. Munier FL. et al. Treatment of retinoblastoma in 2015: Agreement and disagreement. JAMA
|
|
Ophthalmol, 2015. 133(11): 1341-1347. DOl: 10.100I/jamaop-hthalm01.2015.3108.
|
[5] |
白大勇,史季桐,赵军阳,等.视网膜母细胞瘤的激光治疗.国际眼科纵览,2007,3 1 (4): 282-285, 288. DOI: 10.3760/cma.j.
|
|
issn.1673-5803.2007.04.019.
|
[6] |
Shields CL, Lally SE, Leahey AM, et al. Targeted retinoblastoma management: when to use mtravenous. intra-arterial, periocular,and intravitreal chemotherapy. Curr Opin Ophthalmol, 2014. 25(5): 374-385. DOI: 10.1097/ICU.0000000000000091.
|
[7] |
刘万丽,吴中耀,杨华胜,等视网膜母细胞瘤的生存率和预后因素研究中华临床医师杂志(电子版),2010. 4(5): 597-602.DOl: 10.3969/cma.j .issn.1674-0785. 2010.05.013.
|
[8] |
刘秋玲.儿童视网膜母细胞瘤治疗中的若干问题.武警医学院学报,2010, 19(12): 997-998, 1016.
|
[9] |
郁想想,陈长征,赵军阳,等.视网膜母细胞瘤综合治疗疗效分析.武汉大学学报(医学版),2012. 33(2): 247-250. DOI: 10.
|
14 |
18 8/j .1671-8852.2012.02.035.
|
[10] |
Shields JA. Shields CL, Meadows AT. Chemoreduction in the management of retinoblastoma. Am J Ophthalmol, 2005, 140(3):
|
50 |
5-506. DOI: 10 .1016/j. ajo .2005 .04.047.
|
[11] |
Friedman DL, Himelstein B. Shields CL. et al. Chemoreduction and local ophthalmic therapy for intraocular retinoblastoma. J Clin Oncol. 2000, 18(1): 12-17. DOI: 10.1200/JC0.2000.18.1.12.
|
[12] |
Kingston JE, Hungerford JL, Madreperla SA, et al. Results of combined chemotherapy and radiotherapy for advanced
|
|
intraocular retinoblastoma. Arch Ophthalmol, 1996. 114(11):1339-1343.
|
[13] |
Abramson DH, Lawrence SD, Beaverson KL, et al. Systemic carboplatin for retinoblastoma: change in tumour size over time,Br J Ophthalmol, 2005, 89(12): 1616-1619. DOl: 10.1136/bjo.2005.072033.
|
[14] |
Shields CL. Shields JA, Needle M, et al. Combined chemoreduction and adjuvant treatment for intraocular retinoblastoma, Ophthalmology, 1997, 104(12) : 2101-2111 .
|
[15] |
Wilson MW, Rodriguez-Galindo C, Haik BG, et al. Multiagent chemotherapy as neoadjuvant treatment for multifocal
|
|
intraocular retinoblastoma, Ophthalmology, 2001, 108(11):2106-2115. DOI: 10.1016/S0161-6420(01)00805-3.
|
[16] |
郑嵩山,吴中耀,杨华胜,等.视网膜母细胞瘤317例临床分析.眼科研究, 2008, 26(8): 627-629.DOI: 10.3760/cma.j.issn.2095-0160.2008.08.018.
|
[17] |
Honavar SG, Singh AD. Management of advanced retinoblastoma. Ophthalmol Clin North Am. 2005. 18(1): 65-73.viii. DOI: 10.1016/j .ohc.2004.09.001.
|
[1 8] |
Eagle RC. High-risk features and tumor differentiation in retino-blastoma: a retrospective histopathologic study. Arch Pathol Lab Med, 2009, 133(8): 1203-1209. DOI: 10.1043/1543-2165-133 .8.1203.
|
[19] |
Honavar SG, Singh AD, Shields CL. et al. Postenucleation adj uvant therapy in high risk retinoblastoma. Arch Ophthalmol,2002. 120(7) : 923-931. DOI: 10.1001/ archopht.120.7.923 .
|
[20] |
Shields L,孙红,张军军,等.视网膜母细胞瘤的治疗进展.中华眼底病杂志,2004, 20(3): 194-197.
|
[21] |
Shields CL. Mashayekhi A, Au AK. et al.The International Classification of Retinoblastoma predicts chemoreduction success. Ophthalmology, 2006, 113(12): 2276-2280. DOI: 10.1016/j.ophtha.2006.06.018.
|
[22] |
孙宪丽.视网膜母细胞瘤近代治疗眼科,2004, 13(6): 325-330. DOI: 10.3969/j.issn.1004-4469.2004.06.002.
|
[23] |
De Potter P. Current treatment of retinoblastoma. Curr Opin Ophthalmol. 2002, 13(5): 331-336. DOI: 10.109V00055735-
|
20 |
0210000-00007.
|
|
|
|