青蒿琥酯治疗晚期视网膜母细胞瘤的临床疗效与安全性

 目的 探讨青蒿琥酯治疗晚期视网膜母细胞瘤(retinoblastoma, RB)的临床疗效与安全性。方法 总结武警总医院儿科自2012-10至2014-01采用青蒿琥酯联合常规方案(联合治疗组)治疗晚期RB11例患儿的临床资料,并与同期采用常规方案(对照组)治疗的11例晚期RB患儿进行比较,分析总结青蒿琥酯治疗晚期RB的临床疗效及安全性。结果 (1)联合治疗组中4例眼内D、E期患儿中有2例成功保留眼球(50%),5例眼外期患儿中有2例获得手术机会(40%);对照组中7例眼内D、E期的患儿中仅有2例获得保眼机会(28.6%),3例眼外期患儿中有1例获得手术机会(33.3%)。两组间差异均无统计学意义(均P>0.05);(2)截至2015-02-01,联合治疗组的中位无进展生存期(progression-free survival, PFS)和中位总生存期(overall survival, OS)分别为18.2个月和21.8个月,对照组的中位PFS和中位OS分别为18.4个月和21个月,两组间比较差异无统计学意义;(3)所有患儿在给予青蒿琥酯期间均未发生过敏反应,生命体征平稳。两组不良反应的发生率无统计学差异。结论 青蒿琥酯治疗晚期视网膜母细胞瘤有一定疗效,安全性良好。

Clinical effect and safety of artesunate in treatment of advanced retinoblastoma

Objective To study the clinical effect and safety of artesunate combined with conventional therapeutic schedule for children with advanced retinoblastoma. Methods We summarized clinical data of 11 cases who were treated with artesunate combined with conventional therapeutiy with advanced retinoblastoma as combination group between Octobor 1 2012 to January 31 2014 in the General Hospital of Chinese People’s Armed Police Forces. At the same time, 11 cases of advanced retinoblastoma with single conventional therapeutic schedule were selected as control group. The efficacy and safety were reviewed. Results (1)There were two of four(2/4,50%) cases of successfully reserved eyeball in children with intraocular D-E stage, and two cases in five(2/5,40%) received surgery opportunity with extraocular stage in combination group; two cases(2/7,28.6%) of successful reserved eyeball with intraocular D-E stage in seven patients, and one case(1/3,33.3%) received surgey opportunity with extraocular stage in three children in control group. (2)By the end of February 1,2015, the median progression-free survival and the median overall survival were 18.2 months and 21.8 months respectively in the combination group, which compared with control group(the median progression-free survival was 18.4 months and the median overall survival was 21 months), the difference was not statistically significant. (3)All patients did not show allergic reactions during the artesunate therapy and vital signs were stable. No significant difference was found in toxicity between the the two groups (P>0.05). Cnclusion Preliminary study results show that artesunate used for clinical treatment of advanced RB has certain curative effect without extra side effects.