儿童视网膜母细胞瘤临床特点分析

发布时间：2018-05-01 02:04

本文选题：视网膜母细胞瘤 + 儿童　；参考：《南京医科大学学报(自然科学版)》2017年12期

【摘要】：目的 :分析视网膜母细胞瘤患者的临床特点。方法 :对21例(23只眼)视网膜母细胞瘤患者的临床资料进行回顾性分析。结果:21例中男10例,女11例,总体平均诊断年龄(17.9±9.8)个月。初诊主要表现为白瞳症(猫眼样反光),占57.14%。通过CT或(和)MRI检查21例患者均有球内不规则钙化病灶。根据国际Rb IRC分期21例患者均在C~E期,除2例自动放弃治疗外,其余19例采取VEC标准化疗方案,其中9例在VEC方案治疗后接受玻璃体切割术,4例行眼球摘除术,1例接受自体干细胞移植。随访近3年其中2例放弃治疗死亡,6例VEC疗程中失访,3例1年内复发,其中2例局部复发,予眼球摘除术,1例局部复发伴有颅内转移,接受奥沙利铂+伊立替康+替莫唑胺化疗后颅内转移灶消失。11例目前治疗结束,无病生存。结论:视网膜母细胞瘤患者发病年龄小,85%以上3岁前发病,白瞳症为其常见首发症状。眼底镜、CT及MRI均可帮助其临床诊断,且CT平扫显示眼球内钙化灶及病理检查有确诊价值。全身化疗联合局部治疗仍是理想的治疗方法。
[Abstract]:Objective: to analyze the clinical features of retinoblastoma. Methods: the clinical data of 21 patients with retinoblastoma (23 eyes) were analyzed retrospectively. Results there were 10 males and 11 females in 21 cases. The average age of diagnosis was 17.9 卤9.8 months. The main manifestations of first diagnosis were white pupil (cat's eye reflex, 57.14). Irregular calcification lesions were detected in 21 cases by CT or MRI. According to the international RB IRC staging, 21 patients were in stage E, 19 patients were treated with standard chemotherapy regimen of VEC, except for 2 patients who voluntarily gave up treatment. 9 cases underwent vitrectomy after VEC regimen and 1 case received autologous stem cell transplantation. In the follow-up of nearly 3 years, 2 cases died of giving up treatment and 6 cases died of VEC. In the course of VEC, 3 cases recurred within 1 year, 2 cases of them recurred locally, and 1 case of local recurrence accompanied with intracranial metastasis after enucleation of eyeball. The intracranial metastases disappeared after oxaliplatin iriticecomozolium chemotherapy. 11 cases were cured and survived. Conclusion: the age of retinoblastoma is over 85%, and the first symptom is mydriasis. Fundus CT and MRI can be helpful in clinical diagnosis, and plain CT scan is valuable for diagnosis of intraocular calcification and pathological examination. Systemic chemotherapy combined with local treatment is still an ideal treatment.
【作者单位】：南京医科大学第一附属医院儿科;南京医科大学第一附属医院眼科;
【基金】：国家自然科学基金(81170487)
【分类号】：R739.7

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