VEC方案联合激光治疗RB眼内期患儿的效果与安全性

目的：评价VEC方案联合激光治疗不同年龄视网膜母细胞瘤(RB)眼内期患儿的效果与安全性。

方法：选择我院2016-01/2018-03 RB眼内期患儿63例作为研究对象，根据年龄分为≤1岁组23例36眼，>1岁组40例66眼，均给予VEC方案联合激光治疗，参照国际抗癌联盟制定的疗效标准评价疗效。治疗前、6个疗程结束后采用间接检眼镜与超声下测量肿瘤及肿瘤基底厚度与直径，记录治疗期间毒副反应。

结果：≤1岁组缓解率为75.0%，>1岁组缓解率为92.4%(P<0.05)。≤1岁组进展5眼，>1岁组进展1眼均行眼球摘除，其余患眼治疗后肿瘤厚度与基底直径明显小于治疗前(P<0.05)。>1岁组治疗后肿瘤厚度与基底直径均比≤1岁组小(P<0.05)。两组患儿均有轻度恶心呕吐等消化道症状及脱发，≤1岁组各有1例轻度骨髓抑制和肝功能损害，>1岁组有2例轻度骨髓抑制，1例轻度肝功能损害。

结论：VEC方案联合激光治疗RB眼内期患儿安全可行，>1岁患儿疗效优于≤1岁患儿。

Efficacy and safety of VEC combined with laser in treatment of children with intraocular RB

AIM: To evaluate the efficacy and safety of VEC combined with laser in treatment of retinoblastoma(RB)in children with different ages.

METHODS: Totally 63 children with RB intraocular phase in our hospital were selected as subjects. According to their ages, they were divided into 1 year old group(n=23, 36 eyes), >1 year old group(n=40, 66 eyes). All of them were treated with VEC combined with laser therapy. Indirect ophthalmoscope and ultrasound were used to measure the thickness and diameter of tumor and tumor base before treatment and after 6 treatment courses.

RESULTS: The remission rate in the 1 year old group was 75.0%, and that in the >1 year old group was 92.4%(P<0.05). In the 1 year old group, 5 eyes were developed, and in the >1 year old group, 1 eye was removed. The average tumor thickness and average base diameter of the remaining eyes after treatment were significantly smaller than those before treatment(P<0.05). The mean thickness and mean diameter of base of >1 year old group were smaller than those of 1 year old group(P<0.05). Two groups of children had mild nausea and vomiting and other gastrointestinal symptoms and hair loss,1 year old group had 1 case of mild myelosuppression and liver function damage, >1 year old group had 2 cases of mild myelosuppression,1 case of mild liver function damage.

CONCLUSION:VEC combined with laser is safe and feasible in the treatment of children with intraocular RB. >1 year old group is better than 1 year old group.