Gombos D S, Cauchi P A, Hungerford J L, Addison P, Coen P G, Kingston J E
Ocular Oncology Service, Bart's and The London NHS Trust, London, UK.
Br J Ophthalmol. 2006 Sep;90(9):1168-72. doi: 10.1136/bjo.2006.091223. Epub 2006 May 17.
To evaluate rates of vitreous relapse among retinoblastoma patients treated with primary chemotherapy and assess diode laser as a potential risk factor for relapse.
Retrospective review of all patients treated with primary chemotherapy at a large ocular oncology centre. Eyes that developed vitreous relapse were coded with regard to Reese-Ellsworth Group, laterality, time to relapse, type of relapse (vitreous base or non-vitreous base relapse), treatments used (including adjuvant diode laser), and ocular preservation. Individual tumour foci treated with laser hyperthermia were also coded for laser parameters including power settings, number of treatments, and concomitant administration of systemic chemotherapy (chemothermotherapy).
15 of 106 eyes (14.15%) developed vitreous relapse over a 6 year period. Mean time to relapse was 7.2 months after chemotherapy was completed. Five cases (33%) were of the vitreous base variety. Ocular salvage was attempted in 11 cases using a variety of methods; one patient was lost to follow up. Six of the remaining 10 eyes (60%) were salvaged. Eight of 38 eyes (21%) treated with systemic chemotherapy and laser hyperthermia developed vitreous relapse compared with seven of 68 eyes (10%) treated with primary chemotherapy alone (p<0.005). Laser settings, number of hyperthermia treatments, and the concomitant use of systemic chemotherapy (chemothermotherapy) were not associated with higher rates of vitreous relapse.
Nearly one in seven eyes with retinoblastoma treated with primary chemotherapy may develop vitreous relapse. The administration of diode laser hyperthermia appears to increase this risk. Despite additional therapy a number of these eyes succumb to enucleation.
评估接受原发性化疗的视网膜母细胞瘤患者的玻璃体复发率，并评估二极管激光作为复发的潜在危险因素。
对一家大型眼科肿瘤中心接受原发性化疗的所有患者进行回顾性研究。对发生玻璃体复发的眼睛按照里斯 - 埃尔斯沃思分组、患侧、复发时间、复发类型（玻璃体基底部或非玻璃体基底部复发）、所采用的治疗方法（包括辅助二极管激光治疗）以及眼球保留情况进行编码。对接受激光热疗的单个肿瘤病灶也记录激光参数，包括功率设置、治疗次数以及全身化疗（化疗热疗）的联合使用情况。
在6年期间，106只眼中有15只（14.15%）发生玻璃体复发。化疗结束后至复发的平均时间为7.2个月。5例（33%）为玻璃体基底部复发类型。使用多种方法对11例患者尝试进行眼球挽救；1例患者失访。其余10只眼中有6只（60%）成功挽救。接受全身化疗和激光热疗的38只眼中有8只（21%）发生玻璃体复发，而仅接受原发性化疗的68只眼中有7只（10%）发生玻璃体复发（p<0.005）。激光设置、热疗次数以及全身化疗（化疗热疗）的联合使用与较高的玻璃体复发率无关。
接受原发性化疗的视网膜母细胞瘤患者中，近七分之一的眼睛可能发生玻璃体复发。二极管激光热疗的应用似乎增加了这种风险。尽管进行了额外治疗，许多此类眼睛最终仍需眼球摘除。
