视网膜母细胞瘤立体定向放射治疗16例临床分析  

Preliminary study of stereotactic radiotherapy for retinoblastoma

作　　者：宋轶鹏[1,2] 胡立宽[2] 竺鑫丽[2] 王云彦[2] 孙振远[2] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院放疗科,烟台264000 [2]山东大学医学院附属齐鲁医院放疗科,济南250000

出　　处：《癌症进展》2009年第6期669-674,共6页Oncology Progress

摘　　要：目的为提高视网膜母细胞瘤(RB)的肿瘤控制率并保留患眼及其部分视力探索新的治疗途径,初步探讨视网膜母细胞瘤立体定向放射治疗的疗效。方法16例16眼RB行"微真空角膜接触眼球固定器"(MVCCOP)眼球固定下立体定向放射治疗(X-刀)。单次照射2例,剂量分别为1900cGy和2200cGy;分次照射14例,剂量为3600～4200cGy(分3～4次,1200～1400cGy/F,2～3周完成)和3000cGy(分6次,500cGy/F,6周完成)。参考剂量曲线90%～100%,准直器5～30mm。结果随访6～23个月,中位随访15个月。12例患儿保留眼球及原有视力,肿瘤缩小或者消失;4例因肿瘤复发眼球摘除术;2例死亡。肿瘤控制率达87.5%,眼球保留率75%。除发生不同程度视网膜剥脱外,全组病例未见其他并发症。结论立体定向放射治疗对RB是一种安全有效的新疗法,可有效控制肿瘤的复发与转移,减少并发症的发生,还可以保留眼球和部分视力,提高生存质量。MVCCOP做眼球固定,定位精度高,效果满意。Objective To investigate the result of stereotactic radiotherapy （SRT） for retinoblastoma, a new approach of treatment with improvement of the tumor control and conservation of partial vision. Methods From July 2003 to July 2005, 16 patients with retinoblastoma were treated with SRT, under the eyeball fixation, MVCCOP. Among them, 2 patients with partial vision received only a single dose of 1900 and 2200cGy, respectively; the other 14 received FSRT, with 3600 -4200 cGy/3 -4fractions/14 -21days for 13 patients and 3000cGy/6 fractions/42days for 1 patient. The reference dose was defined with 90% - 100% isodose covering the target in patients with 5 - 30mm collimater. Results The median follow-up was 15 months, ranging from 6 months to 23 months. The mean survival time was 10 months and the median survival time was 15 months. Fourteen patients survived while 2 died. In 10 patients, the tumor lesion shrank or disappeared and their eyeballs with partial vision were conserved. All patients were free from complications except for retina detachments in different degree. Conclusion SRT is a safe and effective treatment for retinoblastoma. It can control the disease and keep the involved eyeball and partial eyesight conserved in some patients.

关 键 词：视网膜母细胞瘤 立体定向放射治疗 X-刀 

分 类 号：R734.2[医药卫生—肿瘤]