高危视网膜母细胞瘤患者的术后辅助化疗  

Adjuvant chemotherapy for the patients with high risk retinoblastoma ： analysis of 268 cases

作　　者：张浩[1] 颜建华[1] 陈智聪[1] 吴中耀[1] 李永平[1] 杨华胜[1] 毛羽翔[1] 艾思明[1] 张平[1] 钟秀凤[1] 

机构地区：[1]中山大学中山眼科中心,眼科学国家重点实验室,广州510060

出　　处：《中国实用眼科杂志》2007年第10期1090-1093,共4页Chinese Journal of Practical Ophthalmology

基　　金：广东省自然科学基金（编号036651）

摘　　要：目的探讨术后辅助化疗对高危视网膜母细胞瘤（Rb）患者生存及预后的影响。方法收集1997～2004年于中山眼科中心诊治的268例Rb患者资料,随访了135例,其中男80例,女55例;单眼107例,双眼28例。分析患者的一般状况、病理结果、治疗情况、生存率等。用SPSS13.0软件包进行统计学分析。结果135例患者中经治疗但未行化疗75例,曾行化疗51例,未行治疗9例;存活111例（其中1例双眼患者的未摘除眼肿瘤仍有进展）,死亡24例,主要死亡原因为肿瘤颅内蔓延。51例化疗患者中存活46例,死亡5例。未经化疗的患者总体生存率略低于经过化疗的患者,两者间无统计学差异（P=0.369）。眼外期患者中化疗组生存率明显高于未经化疗组,两者间有统计学差异（P=0.000）。未行化疗的患者与经过化疗的患者Ⅰ期义眼座植入后暴露率无统计学差异（P=0.815）。结论术后辅助化疗对有复发和转移高危因素的视网膜母细胞瘤患者可提高其生存和预后,多数患者可耐受化疗的副作用,建议对此类患者术后辅以化疗。Purpose To study the effect of adjuvant chemotherapy on the prognosis of patients with high risk retinoblastoma （Rb）, Methods There were 268 patients with retinoblastoma seen in Zhongshan Ophthalmic Center, Sun Yatosen University between 1997 and 2004 and 135 were followed up, among whom 80 were male, 55 were female, 107 were unilaterally involved, 28 were bilaterally involved. The general data, pathologic involvement, therapeutic methods and survival or death of the patients with Rb were retrospectively analyzed. SPSS 13.0 was used for statistical analysis. Results Among 135 patients, 75 underwent treatment but without chemotherapy, 51 underwent chemotherapy, 9 refused to accept any treatment. 111 survived （ 1 survived with active retinoblastoma of the other unenucleated eye ） and 24 died. The patients died mainly due to brain involvement, of 51 patients with chemotherapy, 46 survived and 5 died. The difference between the survival rate of patients with chemotherapy and that without chemotherapy showed no statistical significance （P=0.369）. For the patients with extraocular retinoblastoma, the survival rate of patients with chemotherapy was remarkably higher than that without chemotherapy （P=0.000）. The exposure of implanted prosthesis had no relation with chemotherapy （P=0.815）. Conclusions The adjuvant chemotherapy after operation has improved the survival and prognosis of the patients with high risks of tumor relapse or metastasis and most patients can sustain the side effects of chemotherapy, thus adjuvant chemotherapy was suggested for these patients.

关 键 词：视网膜母细胞瘤 肿瘤 治疗 辅助化疗 

分 类 号：R739.7[医药卫生—肿瘤]