Shin Joo Young, Kim Jeong Hun, Yu Young Suk, Khwarg Sang In, Choung Ho Kyung, Shin Hee Young, Ahn Hyo Seop
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2010 Aug;24(4):219-24. doi: 10.3341/kjo.2010.24.4.219. Epub 2010 Aug 3.
To evaluate the efficacy of primary chemotherapy combined with local therapy in the treatment of retinoblastomas not treatable with a single therapeutic method.
We performed a retrospective chart review of 227 patients diagnosed with retinoblastoma. Sixty-five eyes in 52 patients had tumors not treatable with a single therapeutic method and received primary chemotherapy combined with local therapy as needed.
Tumor control and eye salvage was achieved in 34 of the 65 eyes; the probability of ocular survival was 46.56% using the Kaplan-Meier method. Forty-three of the 65 eyes were group D or E tumors, in which tumor control and eye salvage was achieved in 16 eyes. Twenty eyes were treated with chemotherapy only, while 28 eyes received one additional modality of local therapy, and 17 eyes received two modalities of local therapy. Of the eyes treated with chemotherapy only, tumor control was achieved in 5 eyes.
Primary chemotherapy combined with local therapy can be effective and safe in the treatment of retinoblastomas otherwise untreatable with other therapeutic methods, such as group D and E retinoblastomas. More vigorous treatment with more local therapeutic methods combined may yield even better results.
评估原发性化疗联合局部治疗在治疗无法用单一治疗方法治愈的视网膜母细胞瘤中的疗效。
我们对227例诊断为视网膜母细胞瘤的患者进行了回顾性病历审查。52例患者的65只眼中有肿瘤无法用单一治疗方法治愈，并根据需要接受了原发性化疗联合局部治疗。
65只眼中有34只实现了肿瘤控制和眼球挽救；使用Kaplan-Meier方法计算的眼球存活概率为46.56%。65只眼中有43只为D组或E组肿瘤，其中16只实现了肿瘤控制和眼球挽救。20只眼仅接受化疗，28只眼额外接受了一种局部治疗方式，17只眼接受了两种局部治疗方式。仅接受化疗的眼中，有5只实现了肿瘤控制。
原发性化疗联合局部治疗对于其他治疗方法无法治愈的视网膜母细胞瘤（如D组和E组视网膜母细胞瘤）可能是有效且安全的。联合更多局部治疗方法进行更积极的治疗可能会产生更好的效果。
