Advanced Unilateral Retinoblastoma: The Impact of Ophthalmic Artery Chemosurgery on Enucleation Rate and Patient Survival at MSKCC.
Advanced Unilateral Retinoblastoma: The Impact of Ophthalmic Artery Chemosurgery on Enucleation Rate and Patient Survival at MSKCC.
复制标题
晚期单侧视网膜母细胞瘤：眼科化学外科对MSKCC涂料率和患者存活的影响。
DOI：
10.1371/journal.pone.0145436
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Gobin YP
中科院分区：
文献类型：
--
作者：
Abramson DH;Fabius AW;Issa R;Francis JH;Marr BP;Dunkel IJ;Gobin YP
目的报道眼动脉化疗（OAC）对晚期单侧眼内视网膜母细胞瘤儿童的去核率、眼部和转移患者存活率的影响，以及对纪念斯隆凯特琳医院（Memorial Sloan Kettering）手术模式的影响。在我们引入OAC（2006年5月）至2014年12月期间，对所有在MSKCC治疗的单侧视网膜母细胞瘤晚期眼内视网膜母细胞瘤患者进行单中心回顾性研究。终点是眼生存、患者转移生存和去核率。纳入156例视网膜母细胞瘤患者的156只眼。原发性去核率逐渐下降，从使用OAC前的约95%下降到使用OAC第一年的66.7%，再到目前的7.4%。接受OAC治疗的患者比例从2006年的33.3%逐步增加到2014年的92.6%。总体而言，与2006-2009年相比，2010-2014年接受OAC治疗的眼睛的眼部存活率显著提高（p = 0.023, 48个月时的眼部存活率为92.7% vs 68.0%）。在OAC组中没有转移性死亡，但有2例接受原发性去核治疗的患者死于转移性疾病。OAC于2006年推出，对患者管理产生了深远的影响。去核率从95%以上下降到10%以下。自2006年5月以来，我们的眼部存活率也显著提高。尽管治疗较晚期的眼睛而不是去核，但患者的生存并未受到影响（在OAC组中没有转移性死亡）。在我们的机构，去核不再是最常见的治疗晚期单侧视网膜母细胞瘤。
To report on the influence of ophthalmic artery chemosurgery (OAC) on enucleation rates, ocular and patient survival from metastasis and impact on practice patterns at Memorial Sloan Kettering for children with advanced intraocular unilateral retinoblastoma. Single-center retrospective review of all unilateral retinoblastoma patients with advanced intraocular retinoblastoma treated at MSKCC between our introduction of OAC (May 2006) and December 2014. End points were ocular survival, patient survival from metastases and enucleation rates. 156 eyes of 156 retinoblastoma patients were included. Primary enucleation rates have progressively decreased from a rate of >95% before OAC to 66.7% in the first year of OAC use to the present rate of 7.4%. The percent of patients receiving OAC has progressively increased from 33.3% in 2006 to 92.6% in 2014. Overall, ocular survival was significantly better in eyes treated with OAC in the years 2010–2014 compared to 2006–2009 (p = 0.023, 92.7% vs 68.0% ocular survival at 48 months). There have been no metastatic deaths in the OAC group but two patients treated with primary enucleation have died of metastatic disease. OAC was introduced in 2006 and its impact on patient management is profound. Enucleation rates have decreased from over 95% to less than 10%. Our ocular survival rate has also significantly and progressively improved since May 2006. Despite treating more advanced eyes rather then enucleating them patient survival has not been compromised (there have been no metastatic deaths in the OAC group). In our institution, enucleation is no longer the most common treatment for advanced unilateral retinoblastoma.