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视网膜母细胞瘤:来自印度北部一家三级护理机构的16年临床表现、治疗及结果回顾。

Retinoblastoma: A Sixteen-Year Review of the Presentation, Treatment, and Outcome from a Tertiary Care Institute in Northern India.

作者信息

Singh Usha, Katoch Deeksha, Kaur Savleen, Dogra Mangat Ram, Bansal Deepak, Kapoor Rakesh

机构信息

Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Ocul Oncol Pathol. 2017 Dec;4(1):23-32. doi: 10.1159/000477408. Epub 2017 Jul 5.

Abstract

PURPOSE

To study epidemiology, demographic profile, clinical characteristics, and outcome in pediatric patients with retinoblastoma.

METHODS

This was a retrospective review of retinoblastoma patients of a tertiary institute from January 1st 1998 to December 31st 2014.

RESULTS

The study included 467 patients (618 eyes) with a mean age of 34.7 ± 24.6 months (median = 30; 15 days to 144 months). Retinoblastoma was bilateral in 151 (32.3%) and there were 61.7% males. Intraocular disease was seen in 301 patients (451 eyes [72.9%]) and extraocular in 166 patients (167 eyes; 27.0%). Out of the 347 (74.3%) who received treatment, primary treatment was chemoreduction in 228 (65.7%) and enucleation in 117 (33.7%), while 25.6% of patients refused treatment and 151 (43.5%) defaulted therapy. Local recurrence was seen in 20 (4.3%), metastasis in 2 (0.4%), and deaths in 13 (2.8%) (average follow-up 28.5 ± 44.4 months). Histopathological high risk features were significantly less in the eyes that received chemoreduction (5.0%) versus primary enucleation (20.8%) ( < 0.0004), but there was no difference in the rate of metastasis, recurrence, and death between the two.

CONCLUSIONS

The majority of retinoblastoma patients in our study had advanced disease, and nearly a third had extraocular extension. There were a significant number of therapy refusals and dropouts. Chemoreduction led to a significant decrease in the histopathological risk factors without affecting the outcomes.

摘要

目的

研究视网膜母细胞瘤患儿的流行病学、人口统计学特征、临床特点及预后。

方法

这是一项对某三级医疗机构1998年1月1日至2014年12月31日期间视网膜母细胞瘤患者的回顾性研究。

结果

该研究纳入467例患者(618只眼),平均年龄为34.7±24.6个月(中位数=30;15天至144个月)。视网膜母细胞瘤为双侧性的有151例(32.3%),男性占61.7%。301例患者(451只眼[72.9%])为眼内疾病,166例患者(167只眼;27.0%)为眼外疾病。在接受治疗的347例(74.3%)患者中,初始治疗采用化疗减瘤的有228例(65.7%),眼球摘除术的有117例(33.7%),而25.6%的患者拒绝治疗,151例(43.5%)未完成治疗。局部复发20例(4.3%),转移2例(0.4%),死亡13例(2.8%)(平均随访28.5±44.4个月)。接受化疗减瘤的眼组织病理学高危特征(5.0%)明显少于初次眼球摘除术的眼(20.8%)(P<0.0004),但两者之间的转移、复发和死亡率无差异。

结论

我们研究中的大多数视网膜母细胞瘤患者病情已进展,近三分之一有眼外扩展。有相当数量的患者拒绝治疗和退出治疗。化疗减瘤导致组织病理学危险因素显著降低,且不影响预后。

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