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2025年视网膜母细胞瘤的管理

Managing retinoblastoma in 2025.

作者信息

Ramos-Dávila Eugenia M, Williams Basil K, Di Nicola Maura

机构信息

Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences., Monterrey, Mexico.

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

Curr Opin Ophthalmol. 2025 Sep 1;36(5):414-426. doi: 10.1097/ICU.0000000000001155. Epub 2025 Jun 5.

Abstract

PURPOSE OF REVIEW

The management of retinoblastoma is an evolving field, with ongoing research focused on novel diagnostic techniques and therapeutic interventions. This review aims to summarize the current treatment options for retinoblastoma and explore future directions in the field.

RECENT FINDINGS

Early diagnosis remains crucial for improving prognosis in retinoblastoma, as prompt identification significantly enhances treatment success. New diagnostic imaging strategies as well as prenatal testing are being developed to detect subclinical disease in high-risk patients, allowing for earlier intervention. Recurrent or refractory disease remains a challenge, but encouraging results have been observed with intravenous chemotherapy, intra-arterial chemotherapy, and intravitreal chemotherapy as salvage therapies. Other strategies, including anterior chamber chemotherapy, novel drug formulations, and advanced delivery methods like sustained release chemotherapy in the form of a chemoplaque, are being explored to address these persistent challenges.

SUMMARY

Significant progress in retinoblastoma treatment has led to a dramatic improvement in globe salvage rates. Nevertheless, challenges remain. Delayed diagnosis, particularly in low-income and middle-income regions, continues to contribute to reduced survival rates. Additionally, the management of advanced disease, as well as recurrent or refractory tumors, remain critical issues. The development of new drugs and delivery methods as well as modified treatment strategies offer promise in overcoming these obstacles.

摘要

综述目的

视网膜母细胞瘤的管理是一个不断发展的领域,目前的研究集中在新型诊断技术和治疗干预措施上。本综述旨在总结视网膜母细胞瘤的当前治疗选择,并探索该领域的未来发展方向。

最新发现

早期诊断对于改善视网膜母细胞瘤的预后仍然至关重要,因为及时识别可显著提高治疗成功率。正在开发新的诊断成像策略以及产前检测方法,以在高危患者中检测亚临床疾病,从而实现更早的干预。复发性或难治性疾病仍然是一个挑战,但静脉化疗、动脉内化疗和玻璃体内化疗作为挽救疗法已观察到令人鼓舞的结果。正在探索其他策略,包括前房化疗、新型药物制剂以及如化疗斑块形式的缓释化疗等先进给药方法,以应对这些持续存在的挑战。

总结

视网膜母细胞瘤治疗取得的重大进展已使眼球挽救率显著提高。然而,挑战依然存在。诊断延迟,尤其是在低收入和中等收入地区,仍然导致生存率降低。此外,晚期疾病以及复发性或难治性肿瘤的管理仍然是关键问题。新药物和给药方法的开发以及改良治疗策略有望克服这些障碍。

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