本文選題：視網(wǎng)膜母細(xì)胞瘤 + 兒童�。� 參考：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年12期

【摘要】：目的 :分析視網(wǎng)膜母細(xì)胞瘤患者的臨床特點(diǎn)。方法 :對(duì)21例(23只眼)視網(wǎng)膜母細(xì)胞瘤患者的臨床資料進(jìn)行回顧性分析。結(jié)果:21例中男10例,女11例,總體平均診斷年齡(17.9±9.8)個(gè)月。初診主要表現(xiàn)為白瞳癥(貓眼樣反光),占57.14%。通過(guò)CT或(和)MRI檢查21例患者均有球內(nèi)不規(guī)則鈣化病灶。根據(jù)國(guó)際Rb IRC分期21例患者均在C~E期,除2例自動(dòng)放棄治療外,其余19例采取VEC標(biāo)準(zhǔn)化療方案,其中9例在VEC方案治療后接受玻璃體切割術(shù),4例行眼球摘除術(shù),1例接受自體干細(xì)胞移植。隨訪近3年其中2例放棄治療死亡,6例VEC療程中失訪,3例1年內(nèi)復(fù)發(fā),其中2例局部復(fù)發(fā),予眼球摘除術(shù),1例局部復(fù)發(fā)伴有顱內(nèi)轉(zhuǎn)移,接受奧沙利鉑+伊立替康+替莫唑胺化療后顱內(nèi)轉(zhuǎn)移灶消失。11例目前治療結(jié)束,無(wú)病生存。結(jié)論:視網(wǎng)膜母細(xì)胞瘤患者發(fā)病年齡小,85%以上3歲前發(fā)病,白瞳癥為其常見(jiàn)首發(fā)癥狀。眼底鏡、CT及MRI均可幫助其臨床診斷,且CT平掃顯示眼球內(nèi)鈣化灶及病理檢查有確診價(jià)值。全身化療聯(lián)合局部治療仍是理想的治療方法。
[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 鹵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.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院兒科;南京醫(yī)科大學(xué)第一附屬醫(yī)院眼科;
【基金】：國(guó)家自然科學(xué)基金(81170487)
【分類號(hào)】：R739.7

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