一家三级医疗保健医院视网膜母细胞瘤患者接受 6 个周期初级静脉化疗后的复发情况

H. A. Khaqan, Hasnain Muhammad Bukhsh, Hafiz Ateeq ur Rehman, L. Hassan, Muhammad Usman Zia, A. Fauzan, Asad Mahmood Khan, Ahmed Arsalan
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摘要

目的确定一家三级医疗保健医院视网膜母细胞瘤患者在接受 6 个周期的初级静脉化疗后的复发频率。材料与方法: 本研究于 2020 年 3 月 15 日至 2020 年 9 月 15 日在拉合尔拉合尔总医院眼科进行。从门诊部随机抽取了 81 名患者。所设计的表格用于收集数据,包括姓名、年龄、性别、登记号、侧位、诊断时的年龄、疾病类型、所接受的治疗和治疗结果。疾病分类采用了国际眼内视网膜母细胞瘤分类法(IIRC)。化疗方案为长春新碱、依托泊苷和卡铂(VEC)。共进行了 6 个周期的化疗,每周期间隔 3 周。对肿瘤进行连续监测,以排除局部复发或治疗副作用。治疗结果共有81名视网膜母细胞瘤患儿参与了这项研究。其中男性52人(64.2%),女性29人(35.8%)。患者平均年龄为(3.41±1.45)岁。61名(75.30%)患者为单侧发病,20名(24.70%)患者为双侧视网膜母细胞瘤。81 名儿童中有 20 人(24.7%)复发。结论24.7%的视网膜母细胞瘤患者在接受静脉化疗后复发。年龄较小、肿瘤较晚期、位于后方、发病时有视网膜下种子的患者复发风险较高,但通常可通过保球疗法控制复发。
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Outcome of 6 Cycles of Primary Intravenous Chemotherapy of Retinoblastoma Patients in Terms of Recurrence in a Tertiary Health Care Hospital
Objective: To determine the frequency of recurrence after 6 cycles of primary intravenous chemotherapy of retinoblastoma patients in a tertiary health care hospital. Materials and Methods:  This study was conducted at the Department of Ophthalmology, Lahore General Hospital, Lahore from March 15, 2020 to September 15, 2020. A total of 81 patients were selected randomly from outpatient department. Performa designed was used to collect data including name, age, gender, registration number, laterality, age at diagnosis, group of disease, treatment given and outcomes of given treatment. International Intraocular Retinoblastoma Classification (IIRC) was used for classification of the disease. The chemotherapy regimen used was vincristine, etoposide and carboplatin (VEC). A total of 6 cycles were given at 3 weekly intervals. Serial monitoring of the tumors was done to rule out any local recurrence or side effects of therapy. Results: Total 81 children presenting with retinoblastoma were enrolled in this study. There were 52(64.2%) male and 29(35.8%) female. The mean age of patients was 3.41±1.45 year. Unilateral disease was in 61 (75.30%) patients while 20 (24.70%) patients had bilateral retinoblastoma. Among 81 children, 20(24.7%) had recurrence of the disease. Conclusion: Development of recurrence after intravenous chemotherapy was noted in 24.7 % of all retinoblastoma eyes. Younger patients with more advanced, posteriorly located tumors and subretinal seeds at presentation were at increased risk, but recurrence can often be managed with globe-sparing therapy.
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