眼球保存治療を行った網膜芽細胞腫の9例

Nine treated cases of retinoblastoma preserving the eyeglobe

要約　目的：網膜芽細胞腫に対し眼球保存治療を行った9例の報告。対象と方法：対象は2001～2010年に九州大学病院で治療した網膜芽細胞腫41例のうち保存治療を行った9例9眼。診療録から治療経過などを後ろ向きに調査した。結果：両眼性が8例，片眼性が1例であった。両眼性は進行眼を摘出し僚眼に保存治療を行った。国際分類の内訳はA群0眼，B群5眼，C群4眼，D群0眼，E群0眼であった。全例で全身化学療法とダイオードレーザー治療を行い，メルファラン硝子体注入2眼，小線源治療2眼，放射線外照射2眼，選択的眼動脈注入1眼を行った。結論：眼球保存治療を行った9眼は重篤な副作用がなく，国際分類B群で5眼（100％），C群で3眼（75％），眼球保存を達成した。

Abstract.　Purpose：To report 9 cases of retinoblastoma treated by conservative means. Cases and Method：This retrospective study was made on 9 cases out of a consecutive series of 41 cases of retinoblastoma treated by us during the past 10 years. The 9 cases comprised 1 unilateral and 8 bilateral cases. Bilateral cases received enucleation of more advanced eye with the fellow eye treated by preserving the eyeglobe. Results：According to the international classification, 5 eyes belonged to group B and 4 eyes to group C. All the 9 cases received systemic chemotherapy and diode laser irradiation. Intravitreal injection of melphalan was additionally performed in 2 cases, plaque radiotherapy in 2 cases, external beam radiotherapy in 2 cases, and selective ophthalmic arterial injection in one case. Visual function was well-preserved in 7 out of the 9 eyes without major complications during the follow-up for 9 to 121 months, average 61 months. Conclusion：All the 5 eyes of retinoblastoma belonging to group B and 3 out of 4 eyes belonging to group C were successfully treated by conservative means without severe side effects.