CTV化疗方案治疗视网膜母细胞瘤的不良反应及其防治

摘要

Objective To observe the related toxicity of CTV (carboplatin, teniposide, vincristine) chemotherapy as a conditioning regimen in patients with retinoblastoma, and explore the prevention and treatment measures. Methods 154 cases of retinoblastoma who undertook chemotherapy were collected from January to December 2008. All patients received CTV chemotherapy (carboplatine 28 mg/kg, teniposide 8 ng/kg and vincristine 0.05 mg/kg) as a conditioning regimen, and the side effects were observed. The toxicity was evaluated according to the World Health Organization classification of chemotherapy side effects. Results The tumor size of the patients who did not receive enucleation decreased obviously at intraocular stage after chemotherapy. Three (1.9％) patients had no side effects of chemotherapy. Chemotherapy associated toxicity was observed in 151 patients, 48 (31.2％) patients with Ⅰ grade toxicity, 64 (41.6％) patients with Ⅱ grade toxicity, 28 (7.1％) patients with Ⅲ grade toxicity and 11 (18.2％) patients with Ⅳ grade toxicity. Major side-effects included hematological, disorder, digestive order, alopecia, seldom fever,allergy and neurotoxicity. All complications except alopecia could completely recovered. Conclusions CTV chemotherapy as a conditioning regimen might be effective and safe for children with retinoblastoma.%目的 观察CTV化疗方案治疗视网膜母细胞瘤的相关不良反应及其防治措施.方法 选取2008年1月至2008年12月临床确诊为视网膜母细胞瘤并化疗的患儿,共154例.采用CTV化疗方案(卡铂28 mg/kg、替尼泊苷8 mg/kg、长春新碱0.05 mg/kg),观察患儿化疗时及化疗后的不良反应.结果 未摘除眼球的眼内期患儿化疗后肿瘤明显缩小.化疗时及化疗后无任何不良反应者3例,占1.9%;有不良反应按WHO化疗不良反应分级为Ⅰ度者48例,占31.2%;Ⅱ度64例,占41.6%;Ⅲ度28例,占18.2%,Ⅳ度11例,占7.1%.不良反应主要为血液系统和消化系统症状、脱发,少数病例出现发热、过敏和周围神经症状;除脱发外,其余不良反应均恢复.结论 CTV化疗方案治疗视网膜母细胞瘤安全、有效.