Cause of death of children with intraocular retinoblastoma in the Beijing Children's Hospital 2009-2017
10.3760/cma.j.cn511434-20220131-00059
- VernacularTitle:北京儿童医院2009年至2017年眼内视网膜母细胞瘤患儿死亡原因分析
- Author:
Shihan ZHANG
1
;
Xiaoli MA
;
Chengyue ZHANG
;
Dayong BAI
;
Yanhui CUI
;
Yan SU
;
Dawei ZHANG
;
Xisi WANG
;
Chao DUAN
;
Junyang ZHAO
;
Mei JIN
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童肿瘤中心肿瘤内科 北京市儿童血液肿瘤重点实验室 儿科重大疾病研究教育部重点实验室, 北京 100045
- Keywords:
Retinoblastoma;
Cause of death;
Antineoplastic combined chemotherapy protocols;
Eye enucleation;
Vitrectomy
- From:
Chinese Journal of Ocular Fundus Diseases
2022;38(3):182-186
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe and analyze the clinical characteristics of children who died of intraocular retinoblastoma (RB).Methods:A retrospective clinical study. Fourteen children (23 eyes) with intraocular RB who died after receiving treatment in Beijing Children's Hospital from 2009 to 2017 were included in the study. Among the children, there were 7 males (10 eyes) and 7 females (13 eyes); 5 had unilateral and 9 had bilateral tumor. Age were 17.2±15.5 months. All children underwent RetCam examination. RB was staged according to the international intraocular RB classify. Among the 23 eyes, 1 eye was in stage B, 2 eyes were in stage C, 12 eyes in stage D, and 8 eyes in stage E. Treatment methods included a systemic (vincristine, etoposide and carboplatin) chemotherapy (VEC chemotherapy), enucleation surgery, and vitrectomy. The basic conditions including age, time of diagnosis, pathological diagnosis, treatment and main causes of death were retrospectively analyzed.Results:Among the 14 cases, the first symptom was leukemia in 12 cases, red eye in 1 case, and squintin in 1 case. Systemic VEC chemotherapy was used for 1-6 courses of treatment; 5 cases were enucleated, 3 cases underwent histopathological examination; 3 cases were treated with vitrectomy. Among the 3 cases who underwent histopathological examination, the sclera and optic nerve, optic nerve and optic disc were invasted respectively. Seven patients died of tumor metastasis and/or intracranial lesions (50.0%, 7/14); the median survival time was 19 months. Four patients died of treatment (28.6%, 4/14), including 3 patients died of chemotherapy-related side effects, and 1 died of organ failure after enucleation surgery (7.1%); the median survival time was 3.5 months. Early abandonment of treatment died in 3 cases (21.4%, 3/14); the median survival time was 15 months.Conclusion:Intracranial metastasis is the main cause of death in children with intraocular RB.
