Rodriguez-Galindo Carlos, Wilson Mathew W, Chantada Guillermo, Fu Ligia, Qaddoumi Ibrahim, Antoneli Célia, Leal-Leal Carlos, Sharma Tarun, Barnoya Margarita, Epelman Sidnei, Pizzarello Louis, Kane Javier R, Barfield Ray, Merchant Thomas E, Robison Leslie L, Murphree A Linn, Chevez-Barrios Patricia, Dyer Michael A, O'Brien Joan, Ribeiro Raul C, Hungerford John, Helveston Eugene M, Haik Barrett G, Wilimas Judith
Department of Oncology, St Jude Children's Research Hospital, 332 N Lauderdale, Memphis, TN 38105, USA.
Pediatrics. 2008 Sep;122(3):e763-70. doi: 10.1542/peds.2008-0518.
Retinoblastoma is curable when diagnosed early and treated appropriately; however, the prognosis is dismal when the basic elements of diagnosis and treatment are lacking. In developing countries, poor education, lower socioeconomic conditions, and inefficient health care systems result in delayed diagnosis and suboptimal care. Furthermore, the complexity of multidisciplinary care required is seldom possible. Whereas ocular salvage is a priority in the Western world, death from retinoblastoma is still a major problem in developing countries. To bring the 2 ends of this spectrum together and provide a forum for discussion, the "One World, One Vision" symposium was organized, at which clinicians and researchers from various cultural, geographic, and socioeconomic backgrounds converged to discuss their experiences. Strategies for early diagnosis in developing countries were discussed. Elements of the development of retinoblastoma centers in developing countries were discussed, and examples of successful programs were highlighted. An important component in this process is twinning between centers in developing countries and mentor institutions in high-income countries. Global initiatives by nongovernmental organizations such as the International Network for Cancer Treatment and Research, Orbis International, and the International Agency for Prevention of Blindness were presented. Treatment of retinoblastoma in developing countries remains a challenge; however, it is possible to coordinate efforts at multiple levels, including public administrations and nonprofit organizations, to improve the diagnosis and treatment of retinoblastoma and to improve the outcome for these children.
视网膜母细胞瘤若能早期诊断并得到恰当治疗是可治愈的;然而,当缺乏诊断和治疗的基本要素时,预后则很糟糕。在发展中国家,教育水平低下、社会经济条件较差以及医疗保健系统效率低下导致诊断延迟和治疗不充分。此外,所需的多学科护理的复杂性很少能够实现。在西方世界,眼部挽救是首要任务,而在发展中国家,视网膜母细胞瘤导致的死亡仍然是一个主要问题。为了弥合这一差距并提供一个讨论的平台,组织了“同一个世界,同一个愿景”研讨会,来自不同文化、地理和社会经济背景的临床医生和研究人员齐聚一堂,分享他们的经验。会上讨论了发展中国家早期诊断的策略。探讨了发展中国家视网膜母细胞瘤中心的发展要素,并重点介绍了成功项目的实例。这一过程中的一个重要组成部分是发展中国家的中心与高收入国家的指导机构结对合作。会上还介绍了国际癌症治疗与研究网络、国际奥比斯组织和国际预防失明机构等非政府组织的全球倡议。发展中国家的视网膜母细胞瘤治疗仍然是一项挑战;然而,通过包括公共管理部门和非营利组织在内的多个层面的共同努力,改善视网膜母细胞瘤的诊断和治疗并提高这些儿童的治疗效果是有可能的。