视网膜母细胞瘤的巩膜敷贴放射治疗疗效观察  

Clinical evaluation of episcleral plaque radiotherapy for retinoblastoma

作　　者：杨新吉[1] 王毅[1] 由德博[2] 王婧[1] 李月月[1] 鲁小中[1] 肖利华[1] 

机构地区：[1]武警总医院眼眶病研究所,北京100039 [2]北京大学第三医院眼科,100083

出　　处：《眼科研究》2008年第1期57-59,共3页Chinese Ophthalmic Research

摘　　要：目的评价巩膜敷贴放射疗法对于视网膜母细胞瘤(Rb)治疗的有效性。方法对用巩膜敷贴放射治疗的Rb患儿16例(18眼)的疗效进行观察分析。结果16例(18眼)Rb患儿经巩膜敷贴放射治疗后,在3～24个月的随访中,肿瘤成功得到控制15眼(83%);发生并发症及转移而摘除眼球3眼。未发现明显全身不良反应。并发症有放射性白内障4眼(22%),继发性青光眼4眼(22%),玻璃体出血3眼(16.7%)。所有患眼均未发生巩膜坏死。1例患儿肿瘤复发并眼外转移。结论巩膜敷贴放射疗法是治疗Rb的一个有效方法。Objective Retinoblastoma is the most important intraocular malignancy of childhood. The management of retinohlastoma has changed in recent years. This study evaluated the efficacy of episcleral plaque radiotherapy for the treatment of retinohlastoma. Methods A review of episcleral plaque radiotherapy was used as a method of management in 18 eyes of 16 patients with retinohlastoma. In the 16 patients,phase Ⅰ-Ⅲ of tumors were in 4 eyes,and those of phase Ⅳ-Ⅴ a were in 8 eyes and Vb phase in 6 eyes. 125I plate was put in episcleral for 5-12 days dependent upon the radiological dose following the system chemotherapy. The follow-up periods was 3-24 months. Results The tumor got control in 15 eyes （83%） after episcleral plaque radiotherapy, and 3 eyes with retinohlastoma were enucleated because of radiation complications and metastasis. ttadiotherapy complications included cataract in 4 eyes （22%） , neovascular glaucoma in 4 eyes （22%） ,vitreous hemorrhage in 3 eyes （ 16. 7% ）. No any scleral necrosis was found during the follow-up. Recurrence and extraocular metastasis of retinoblastoma was seen in 1 eye. The systermic toxic effects of episcleral plaque radiotherapy were mild. Conclusion Episcleral plaque radiotherapy is a very effective method in treating retinoblastoma.

关 键 词：巩膜敷贴放射治疗 视网膜母细胞瘤 并发症 

分 类 号：R739.7[医药卫生—肿瘤]