Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America.
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America.
PLoS One. 2018 Apr 26;13(4):e0195395. doi: 10.1371/journal.pone.0195395. eCollection 2018.
To report on the rate and timing of retinal reattachment and outcomes for retinoblastoma children who have total retinal detachments at presentation to our center and were treated with intra-arterial chemotherapy (ophthalmic artery chemosurgery, OAC).
Single-center retrospective review of retinoblastoma patients who presented with total retinal detachments and were subsequently treated with OAC at MSKCC between May 2006 and July 2016. Endpoints were retinal detachment resolution, visual function, ERG amplitude, ocular survival, and patient survival from metastases.
87 eyes of 84 retinoblastoma patients were included. Using a survival multistate model, by 36 months of follow-up, there was a 54% cumulative probability of complete retinal reattachment and a 76% probability of partial reattachment. 24% of eyes that completely reattached received only OAC without any prior or adjuvant treatments. Eyes that completely reattached were significantly more likely to have been diagnosed at a younger age (p<0.0001) and to have greater initial ERG values (p = 0.006). At final follow-up, 14% of eyes had gained at least 25 μV of ERG activity, and 8.0% had achieved hand motion vision or better, including one to 20/60. 13% of eyes were enucleated. No patient died from metastatic disease, and only one developed metastases.
OAC can successfully treat previously considered "non-salvageable" retinoblastoma eyes with total retinal detachments, promote retinal reattachment in the majority of eyes, and preserve ocular and patient survival.
报告在我们中心就诊的、患有完全性视网膜脱离的视网膜母细胞瘤患儿的视网膜再附着率和时间以及治疗结果，这些患儿接受了眼动脉化疗（眼动脉化疗手术，OAC）。
对 2006 年 5 月至 2016 年 7 月期间在 MSKCC 接受 OAC 治疗的完全性视网膜脱离的视网膜母细胞瘤患者进行单中心回顾性研究。终点是视网膜脱离复位、视力、ERG 幅度、眼存活率和转移性疾病的患者存活率。
84 例视网膜母细胞瘤患儿的 87 只眼纳入研究。使用生存多状态模型，在 36 个月的随访中，完全视网膜复位的累积概率为 54%，部分复位的概率为 76%。24%的完全复位的眼仅接受了 OAC 治疗，而没有任何先前或辅助治疗。完全复位的眼更有可能在更年轻时被诊断（p<0.0001），并且初始 ERG 值更高（p = 0.006）。在最终随访时，14%的眼获得了至少 25 μV 的 ERG 活动，8.0%的眼获得了手动视力或更好的视力，包括一只至 20/60。13%的眼被眼球摘除。没有患者因转移性疾病死亡，只有一名患者发生了转移。
OAC 可成功治疗先前被认为“不可挽救”的完全性视网膜脱离的视网膜母细胞瘤眼，可促进大多数眼的视网膜再附着，并保留眼和患者的存活率。
