Durnov L A, Belkina B M, Poliakov V G, Goldobenko G V, Glekov I V
NII of Pediatric Oncology, ONTs RAMN, Moscow.
Vestn Ross Akad Med Nauk. 1996(10):28-33.
A comprehensive programme was developed for the treatment of uni- and bilateral retinoblastoma in children with due regard to the disease stage by the TNM system. The use of the current sources of teletherapy and cyclic polychemotherapy expanded indications for organ-saving therapy at most common stages. Treatment by the program was performed in 202 patients, including 125 children with unilateral damage and 77 with bilateral damage. An attempt made treat 140 (75%) children at the first stage. More than 70% of cases were diagnosed as having disease stage T3 in one or two stage, while such patients underwent ocular enucleation. A complete or partial (more than 50%) tumor regression without signs of its progression for 2 years or more was achieved in 62% of cases. At the first stage of therapy, conservative therapy insignificantly affected the children's longevity in uncomplicated cases, which is particularly important in bilateral involvement, while this preserved the organ of vision in more than half the patients (62%). Five-year survival was 92 and 82% in unilateral retinoblastoma surgically treated and untreated, 83 and 84%, respectively. Adequate multimodality treatment brought about low incidence rates of recurrence and metastasis (10%) in conservative therapy and 7.7% among all patients.
制定了一项全面计划，用于治疗儿童单眼和双眼视网膜母细胞瘤，并根据TNM系统考虑疾病阶段。使用当前的远距离治疗源和周期性多药化疗扩大了最常见阶段器官保留治疗的适应症。该计划治疗了202例患者，其中包括125名单侧受损儿童和77名双侧受损儿童。试图在第一阶段治疗140名（75%）儿童。超过70%的病例在一个或两个阶段被诊断为疾病T3期，这些患者接受了眼球摘除术。62%的病例实现了肿瘤完全或部分（超过50%）消退，且2年或更长时间无进展迹象。在治疗的第一阶段，在无并发症的情况下，保守治疗对儿童寿命的影响不显著，这在双侧受累时尤为重要，同时在超过一半的患者（62%）中保留了视力器官。接受手术治疗和未接受手术治疗的单侧视网膜母细胞瘤患者的五年生存率分别为92%和82%，分别为83%和84%。充分的多模式治疗在保守治疗中导致复发和转移的发生率较低（10%），在所有患者中为7.7%。
