Imhof S M, Mourits M P, Hofman P, Zonneveld F W, Schipper J, Moll A C, Tan K E
Department of Ophthalmology, Free University Amsterdam, The Netherlands.
Ophthalmology. 1996 Feb;103(2):263-8. doi: 10.1016/s0161-6420(96)30706-9.
The late side effects of external beam irradiation in patients with retinoblastoma such as orbital bony growth retardation, are a serious problem in adolescence. Therefore, a quantitative study was performed to investigate the late effects of irradiation on orbital growth in patients with retinoblastoma.
The orbits of 68 patients with retinoblastoma, 52 bilateral and 16 unilateral, were divided into two treatment groups: radiotherapy alone, 77 orbits; and radiotherapy + enucleation, 43 orbits. Follow-up time was 12 to 240 months (mean, 95 months) in group 1 and 27 to 216 months (mean, 97 months) in group 2. These groups were subdivided further into age groups at which radiotherapy was given. The morphometric measurements of these groups were compared.
The authors showed that irradiation causes a significant growth retardation when compared with the growth of nonirradiated orbits (P<0.001). They also demonstrated that radiotherapy in children younger than 6 months of age is more damaging to the orbital growth than at an older age (P<0.01). Finally, the authors showed that secondary enucleation does not have an additive growth-retarding effect.
Orbital growth retardation in patients with retinoblastoma after radiotherapy is influenced mainly by the age at which irradiation is given and is defined at 6 months. Theoretically, it would be desirable to postpone irradiation in children until they are older than 6 months of age if possible. The irradiation effect on these orbits is not enhanced by enucleation.
视网膜母细胞瘤患者接受外照射后的晚期副作用，如眼眶骨生长迟缓，在青春期是一个严重问题。因此，进行了一项定量研究，以调查放疗对视网膜母细胞瘤患者眼眶生长的晚期影响。
68例视网膜母细胞瘤患者的眼眶，52例双侧和16例单侧，分为两个治疗组：单纯放疗组，77个眼眶；放疗+眼球摘除组，43个眼眶。第1组的随访时间为12至240个月（平均95个月），第2组为27至216个月（平均97个月）。这些组进一步细分为接受放疗时的年龄组。比较这些组的形态学测量结果。
作者表明，与未受照射的眼眶生长相比，照射会导致明显的生长迟缓（P<0.001）。他们还证明，6个月以下儿童接受放疗对眼眶生长的损害比年龄较大时更大（P<0.01）。最后，作者表明二次眼球摘除没有额外的生长迟缓作用。
视网膜母细胞瘤患者放疗后眼眶生长迟缓主要受放疗时年龄的影响，6个月时最为明显。理论上，如果可能的话，最好将儿童的放疗推迟到6个月以上。眼球摘除不会增强对这些眼眶的照射效果。
