Chodick Gabriel, Kleinerman Ruth A, Stovall Marilyn, Abramson David H, Seddon Johanna M, Smith Susan A, Tucker Margaret A
Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7238, USA.
Arch Ophthalmol. 2009 Nov;127(11):1500-4. doi: 10.1001/archophthalmol.2009.271.
To investigate the risk of cataract extraction among adult retinoblastoma survivors.
A retrospective cohort study was performed on retinoblastoma survivors who received the diagnosis from 1914 to 1984 and were interviewed in 2000. Lens doses were estimated from radiotherapy records. The cumulative time interval to cataract extraction between dose groups was compared using the log-rank test and Cox regression.
Seven hundred fifty-three subjects (828 eyes) were available for analysis for an average of 32 years of follow-up. During this period, 51 cataract extractions were reported. One extraction was reported in an eye with no radiotherapy compared with 36 extractions in 306 eyes with 1 course of radiotherapy and 14 among 38 eyes with 2 or 3 treatments. The average time interval to cataract extraction in irradiated eyes was 51 years (95% confidence interval [CI], 48-54) following 1 treatment and 32 years (95% CI, 27-37) after 2 or 3 treatments. Eyes exposed to a therapeutic radiation dose of 5 Gy or more had a 6-fold increased risk (95% CI, 1.3-27.2) of cataract extraction compared with eyes exposed to 2.5 Gy or less.
The results emphasize the importance of ophthalmologic examination of retinoblastoma survivors who have undergone radiotherapy. The risk of cataract extraction in untreated eyes with retinoblastoma is comparable with the risk of the general population.
研究成年视网膜母细胞瘤幸存者进行白内障摘除术的风险。
对1914年至1984年确诊并于2000年接受访谈的视网膜母细胞瘤幸存者进行回顾性队列研究。根据放疗记录估算晶状体剂量。使用对数秩检验和Cox回归比较剂量组之间白内障摘除术的累积时间间隔。
753名受试者（828只眼）可供分析，平均随访32年。在此期间，报告了51例白内障摘除术。未接受放疗的一只眼中报告了1例摘除术，而在接受1疗程放疗的306只眼中有36例摘除术，在接受2或3次治疗的38只眼中有14例。接受1次治疗后，受照射眼睛白内障摘除术的平均时间间隔为51年（95%置信区间[CI]，48 - 54），接受2或3次治疗后为32年（95%CI，27 - 37）。与接受2.5 Gy或更低剂量照射的眼睛相比，接受5 Gy或更高治疗性辐射剂量照射的眼睛白内障摘除术风险增加了6倍（95%CI，1.3 - 27.2）。
结果强调了对接受过放疗的视网膜母细胞瘤幸存者进行眼科检查的重要性。未治疗的视网膜母细胞瘤患眼白内障摘除术的风险与普通人群的风险相当。
