视网膜母细胞瘤化疗减容加局部治疗瘤体后的临床消退类型分析

目的：探讨视网膜母细胞瘤化疗减容加局部治疗后瘤体的消退类型及预后。方法回顾性病例研究。63例（93眼）视网膜母细胞瘤患者在经过化疗减容加局部治疗后的消退类型进行回顾性分析。结果138个视网膜母细胞瘤体消退类型分为五型：0型（n=3），1型（n=19），2型（n=6），3型（n=35），4型（n=75）。肿瘤初始厚度小于或等于3mm的消退类型多为4型（84.21%），初始厚度在3~8mm的肿瘤多为3型（34.43%）和4型（40.98%），初始厚度大于8mm的肿瘤多为1型（35.00%）和3型（50.00%）。在黄斑区的瘤体中常见3型（45.10％）和4型（33.33％）消退类型，在黄斑区-赤道部和赤道部-锯齿缘区的瘤体中常见4型消退类型（54.35％，80.48％）。138个瘤体中其中有14个（10.14%）瘤体复发，其中有2个为0型瘤体，3个为1型瘤体，1个为2型瘤体，8个为3型瘤体。结论化疗减容加局部治疗后4型及3型消退类型最常见。多数小的瘤体转为萎缩瘢痕，中间大小的瘤体多转为萎缩瘢痕或部分钙化残留，大的瘤体多转为完全或部分钙化残留。3型消退类型的瘤体可能易复发。

Retinoblastoma regression patterns following chemoreduction and adjuvant therapy

Objective To evaluate retinoblastoma regression patterns following chemoreduction and adjuvant therapy. Methods Retrospective case series. the regression patterns following chemoreduction and adjuvant therapy of 63 cases （93 eyes） of retinoblastoma patients were researched. Results Retinoblastoma regressions were type 0 （n=3）,type 1 （n=19）,type 2 （n=6）,type 3 （n=35）,and type4 （n=75）. Tumors with an initial thickness of 3 mm or less regressed most often to type 4 （84.21%）,those 3 to 8 mm regressed to type 3（34.43%） or type 4 （40.98%）,and those thicker than 8 mm regressed to type 1 （35.00%） or type 3 （50.00%）. Tumors in the macular area most often to type 3 （45.10%） or type 4 （33.33%）,and those in the macular to equator area and the equator to ora serrata region most often to type 4 （54.35%,80.48%）. 14 tumors recurred,2 tumors were type 0,3 tumors were type 1,1 tumor was type 2 and 8 tumors were type 3. Conclusions Following chemoreduction,type 4 and type 3 regression patterns were most common. Following chemoreduction,most small retinoblastomas result in a flat scar,intermediate tumors in a flat or partially calcified remnant,and large tumors in a more completely calcified remnant. Tumor recurrence was usually found fol-lowing regression pattern type 3.