Howarth C, Meyer D, Hustu H O, Johnson W W, Shanks E, Pratt C
Cancer. 1980 Mar 1;45(5):851-8. doi: 10.1002/1097-0142(19800301)45:5<851::aid-cncr2820450505>3.0.co;2-p.
Forty-two consecutive patients with retinoblastoma were evaluated by a new staging system and combined modality therapy instituted according to stage. Nineteen patients had bilateral tumors and 23 had unilateral tumors. The staging system was effective in identifying subpopulations of patients and successfully predicted those at greater risk of recurrence or death. Thirty-nine of 42 patients survive (Median survival time, 42 months). Two of 4 children with tumor extension beyond the eye died while 37 of 38 children with tumor presumed confined to the eye survive. Toxicity of the chemotherapy was mild. Radiation therapy of intraocular tumor was associated with cataract formation but most children had satisfactory vision after extraction and the use of corrective lenses. Ophthalmologic findings did not always correlate with histologic extent of tumor and both should be used in planning and evaluating treatment. Recommendations are made on the role of chemotherapy and the need to reduce the morbidity of treatment.
采用一种新的分期系统对42例连续性视网膜母细胞瘤患者进行评估，并根据分期实施综合治疗。19例患者为双侧肿瘤，23例为单侧肿瘤。该分期系统可有效识别患者亚群，并成功预测复发或死亡风险较高的患者。42例患者中有39例存活（中位生存时间为42个月）。4例肿瘤扩展至眼外的儿童中有2例死亡，而38例肿瘤推测局限于眼内的儿童中有37例存活。化疗的毒性较轻。眼内肿瘤的放射治疗与白内障形成有关，但大多数儿童在摘除白内障并使用矫正镜片后视力良好。眼科检查结果并不总是与肿瘤的组织学范围相关，在治疗方案的制定和评估中应同时参考这两者。文中就化疗的作用以及降低治疗并发症的必要性提出了建议。
