Habib Larissa A, Francis Jasmine H, Fabius Armida Wm, Gobin Pierre Y, Dunkel Ira J, Abramson David H
Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA.
Br J Ophthalmol. 2018 Feb;102(2):272-275. doi: 10.1136/bjophthalmol-2017-310328. Epub 2017 Jun 9.
BACKGROUND/AIMS: Survivors of retinoblastoma carry a lifetime risk of secondary malignancies. It is well established that external beam radiation increases this risk; however, the risk with ophthalmic artery chemosurgery (OAC) remains unknown. We report on 10 years of experience with OAC and the rate of second primary malignancy (SPM) development.
This is a single-centre retrospective review approved by the Memorial Sloan Kettering Cancer Center Institutional Review Board of all patients who received OAC over a 10-year period, from May 2006 to November 2016. The second tumour incidence and survival in patients with germline disease (bilateral and unilateral with family history or confirmed germline mutation) was estimated using the Kaplan-Meier method. Patients who received external beam radiotherapy were excluded from analyses.
Two hundred and thirty-three patients with heritable retinoblastoma who received OAC were analysed. Nineteen patients were excluded for having received external beam radiation. The Kaplan-Meier estimate of the likelihood for SPM development was 2.7% at 5 years (95% CI 0 to 25). All of the SPMs were pineoblastomas and all patients had bilateral disease in this cohort.
In our 10-year experience, we have found that SPM development in patients with germline retinoblastoma treated with OAC alone is comparable to previously published rates. In the first 10 years, OAC did not increase the known incidence of SPMs. This cohort will continue to be followed to establish the rate of development with extended follow-up.
背景/目的：视网膜母细胞瘤幸存者终生有发生继发性恶性肿瘤的风险。众所周知，外照射会增加这种风险；然而，眼动脉化学手术（OAC）的风险尚不清楚。我们报告了10年的OAC经验以及第二原发性恶性肿瘤（SPM）的发生率。
这是一项单中心回顾性研究，经纪念斯隆凯特琳癌症中心机构审查委员会批准，对2006年5月至2016年11月期间接受OAC治疗的所有患者进行研究。采用Kaplan-Meier方法估计患有遗传性疾病（双侧和有家族史或确诊胚系突变的单侧）患者的第二肿瘤发生率和生存率。接受外照射放疗的患者被排除在分析之外。
分析了233例接受OAC治疗的遗传性视网膜母细胞瘤患者。19例因接受外照射而被排除。5年时SPM发生可能性的Kaplan-Meier估计值为2.7%（95%CI 0至25）。所有SPM均为松果体母细胞瘤，该队列中的所有患者均患有双侧疾病。
根据我们10年的经验，我们发现单独接受OAC治疗的遗传性视网膜母细胞瘤患者的SPM发生率与先前发表的发生率相当。在最初的10年里，OAC并没有增加已知的SPM发生率。该队列将继续随访，以确定延长随访后的发生率。
