视网膜母细胞瘤动脉灌注化疗的并发症单中心研究分析  

Complications of intra-arterial chemotherapy for retinoblastomas:a single-center study analysis

作　　者：吴荣昌[1] 房孝莲 杨磊 张诚玥[4] 赵军阳[5] 彭芸[1] 尤佳 阴捷[1] Wu Rongchang;Fang Xiaolian;Yang Lei;Zhang Chengyue;Zhao Junyang;Peng Yun;You Jia;Yin Jie(Department of Radiology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045;Department of Otolaryngology,Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730;Department of Otolaryngology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045;Department of Ophthalmology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045;Department of Pediatric Oncology Center,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045;Medical Examination Center,Peking University International Hospital,Beijing 102200,China)

机构地区：[1]国家儿童医学中心/首都医科大学附属北京儿童医院影像中心,北京100045 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [3]国家儿童医学中心/首都医科大学附属北京儿童医院耳鼻喉科,北京100045 [4]国家儿童医学中心/首都医科大学附属北京儿童医院眼科,北京100045 [5]国家儿童医学中心/首都医科大学附属北京儿童医院肿瘤中心,北京100045 [6]北京大学国际医院体检中心超声医学科,北京102200

出　　处：《中华介入放射学电子杂志》2025年第1期49-53,共5页Chinese Journal of Interventional Radiology:electronic edition

基　　金：北京市医院管理中心“登峰”计划专项经费资助(DFL20221002)。

摘　　要：目的分析经眼动脉灌注化疗(intra-arterial chemotherapy,IAC)治疗视网膜母细胞瘤的并发症发生情况,为视网膜母细胞瘤患儿的术前治疗方案订制及术后护理提供依据。方法回顾性分析2019年12月至2022年2月在首都医科大学附属北京儿童医院就诊行IAC的96例视网膜母细胞瘤患儿的手术资料。包括肿瘤分期、治疗方法、化疗次数及术后并发症等。按照是否有并发症发生分为2组,采用二元Logistic回归分析术后并发症的影响因素。结果经ICA治疗视网膜母细胞瘤患儿手术并发症包括全身不良反应及眼部并发症。其中19.5%发生骨髓抑制,13.9%为眼动脉血管并发症,0.4%出现药物过敏反应。此外,在96名初次行ICA手术患儿中,31.3%(30/96)出现并发症。在至少接受两次IAC手术患儿的并发症率为37.8%(51/135),首次手术与两次及以上手术并发症相比差异无统计学意义(P=0.306)。单因素及多因素分析结果显示,手术年份是影响并发症的独立风险因素(P<0.05)。结论IAC治疗视网膜母细胞瘤是一种安全有效的方式,术后并发症较轻。Objective To summarize the complications of intra-arterial chemotherapy(IAC)in the treatment of retinoblastomas,in order to provide a basis for the formulation of preoperative treatment plans and postoperative care for children with retinoblastoma,in order to provide a basis for the formulation of preoperative treatment plans and postoperative care for children with retinoblastoma.Methods A retrospective single-center study,including 96 children with retinoblastoma who underwent IAC at the Beijing Children&apos;s Hospital,Capital Medical University between December 2019 and February 2022 was conducted.Data,including tumor stage,treatment method,the number of chemotherapy sessions,and treatment complications,were analyzed.The patients were divided into two groups according to whether complications occurred,and binary Logistic regression analyses was used to analyze the influencing factors of postoperative complications.Results Surgical complications in patients with retinoblastoma treated with IAC included systemic adverse reactions and ocular complications.Among them,19.5%had myelosuppression,13.9%had ophthalmic artery-related complications,and 0.4%had a drug allergy.Moreover,among 96 patients who underwent initial IAC,31.3%(30/96)had treatment complications.The total percentage of complications after 135 infusions in patients who underwent at least two operations was 37.8%(51/135).There was no statistically significant difference in complications between the first IAC and two or more IAC(P=0.306).Both univariate and multivariate analyses revealed that surgical year was an independent risk factor for complications(P<0.05).Conclusion IAC is a safe and effective treatment for retinoblastomas with mild complications.

关 键 词：视网膜母细胞瘤 眼动脉灌注化疗 儿童 并发症 

分 类 号：R739.7[医药卫生—肿瘤]