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眼科肿瘤学:视网膜母细胞瘤、葡萄膜黑色素瘤和结膜黑色素瘤的进展

Ocular oncology: advances in retinoblastoma, uveal melanoma and conjunctival melanoma.

作者信息

Vasalaki Marina, Fabian Ido D, Reddy M Ashwin, Cohen Victoria M L, Sagoo Mandeep S

机构信息

UCL Institute of Ophthalmology, Bath Street, London EC1V 9EL, UK.

Retinoblastoma Service, Royal London Hospital, Whitechapel Road, London E1 1BB, UK.

出版信息

Br Med Bull. 2017 Jan 1;121(1):107-119. doi: 10.1093/bmb/ldw053.

Abstract

BACKGROUND

Retinoblastoma, uveal and conjunctival melanomas are important malignancies within the remit of ocular oncology. Outlined are the diagnostic features and management principles, as well as advancements in the field and current challenges.

SOURCES OF DATA

Original papers, reviews and guidelines.

AREAS OF AGREEMENT

Most eyes with retinoblastoma (International Intraocular Retinoblastoma Classification (IIRC) Group A-D) are salvaged, whereas advanced cases (Group E) remain a challenge. Despite a high rate of local tumour control in uveal melanoma, metastatic spread commonly occurs. Conjunctival melanoma is treated by complete resection, but high rates of local recurrence occur, with the possibility of systemic relapse and death.

AREAS OF CONTROVERSY

Use of the IIRC in retinoblastoma, and systemic screening in melanomas.

GROWING POINTS

Utilization of novel treatment modalities in retinoblastoma and an increasing understanding of the genetic basis of melanomas.

AREAS TIMELY FOR DEVELOPING RESEARCH

Improvements in chemotherapy delivery in retinoblastoma and prognostic tests in melanomas.

摘要

背景

视网膜母细胞瘤、葡萄膜黑色素瘤和结膜黑色素瘤是眼肿瘤学范围内的重要恶性肿瘤。本文概述了其诊断特征、治疗原则,以及该领域的进展和当前面临的挑战。

数据来源

原始论文、综述和指南。

共识领域

大多数视网膜母细胞瘤患者(国际眼内视网膜母细胞瘤分类(IIRC)A-D组)可挽救视力,而晚期病例(E组)仍然是一个挑战。尽管葡萄膜黑色素瘤的局部肿瘤控制率较高,但通常会发生转移扩散。结膜黑色素瘤通过完全切除进行治疗,但局部复发率较高,并有全身复发和死亡的可能。

争议领域

视网膜母细胞瘤中IIRC的使用,以及黑色素瘤的全身筛查。

发展要点

视网膜母细胞瘤中新型治疗方式的应用,以及对黑色素瘤遗传基础的认识不断增加。

亟待开展研究的领域

视网膜母细胞瘤化疗给药的改进和黑色素瘤预后检测。

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