Antoneli Célia B G, Ribeiro Karina C B, Steinhorst Flávio, Novaes Paulo Eduardo R S, Chojniak Martha M, Malogolowkin Marcio
Pediatric Oncology Department, Centro de Tratamento e Pesquisa Hospital do Câncer A.C. Camargo, São Paulo, Brazil.
J Pediatr Hematol Oncol. 2006 Jun;28(6):342-5. doi: 10.1097/00043426-200606000-00004.
To evaluate the efficacy of conservative management of intraocular retinoblastoma with chemoreduction combined with local therapy with or without plaque radiation in the preservation of the eye, and avoidance of external beam radiation therapy (EBRT) (success rate). From 1995 to 2000, 84 newly diagnosed patients with intraocular retinoblastoma were admitted to the Pediatric Department of the Hospital do Cancer A.C. Camargo, São Paulo, Brazil. All children were treated with 2 to 6 cycles of chemotherapy (carboplatin, vincristine, and etoposide) plus local therapy (cryotherapy, laser photocoagulation, and thermotherapy), or plaque radiation therapy during and/or after the chemotherapy. The Mann-Whitney test was used to compare means of quantitative variables. The chi test or the Fisher exact test were employed to verify the association between the outcome and the independent variables. For all tests alpha=5% was adopted. Success rate was higher for patients with bilateral tumors (54%) than for children with unilateral tumors (19%) (P=0.003). For patients with Reese-Ellsworth stages I, II, and III, no statistically significant differences in the success rates were noted in the group of unilateral (50%) and bilateral tumors (79.1%) (P=0.179). Among children with Reese-Ellsworth stages IV and V, the success rate was significantly higher for patients with bilateral tumors (40.7%) than for those with unilateral (0%) (P=0.012). Chemoreduction combined with local therapy, with or without plaque radiotherapy, is efficacious in avoiding enucleation and the use of external beam radiation therapy for children with intraocular retinoblastoma.
为评估眼内视网膜母细胞瘤采用化疗减积联合局部治疗（伴或不伴敷贴放疗）进行保守治疗在保眼及避免外照射放疗（EBRT）方面的疗效（成功率）。1995年至2000年，84例新诊断的眼内视网膜母细胞瘤患者入住巴西圣保罗卡马戈癌症医院儿科。所有儿童均接受2至6个周期的化疗（卡铂、长春新碱和依托泊苷）加局部治疗（冷冻疗法、激光光凝和热疗），或在化疗期间和/或之后接受敷贴放疗。采用曼-惠特尼检验比较定量变量的均值。采用卡方检验或费舍尔精确检验来验证结果与自变量之间的关联。所有检验均采用α=5%。双侧肿瘤患者的成功率（54%）高于单侧肿瘤患儿（19%）（P=0.003）。对于里斯-埃尔斯沃思分期为I、II和III期的患者，单侧肿瘤组（50%）和双侧肿瘤组（79.1%）的成功率无统计学显著差异（P=0.179）。在里斯-埃尔斯沃思分期为IV和V期的儿童中,双侧肿瘤患者的成功率（40.7%）显著高于单侧肿瘤患者（0%）（P=0.012）。化疗减积联合局部治疗，伴或不伴敷贴放疗，对于避免眼内视网膜母细胞瘤患儿眼球摘除及使用外照射放疗是有效的。
