-
- 赵军阳副主任医师
-
医院:
首都医科大学附属北京儿童医院
科室:
眼科
- Retinoblastoma in China Junyang Zhao
- 作者:赵军阳|发布时间:2009-01-22|浏览量:1578次
Published at <Eyes on the World - China>2008
Retinoblastoma (Rb) is a rare eye cancer. About 89% patients were found before 3 years old and 40% were bilateral (both eyes affected). It is reported that the five years survival rate is about 50% in China. The involved children could die if they were not treated properly. China has the one of the most RB children in the world because of her population. There are about 1400 new Rb cases each year in China. Retinoblastoma (RB) is a genetic disease caused by gene defection. For the molecular analysis, only a few research institute can do it for study, but the sensitivity is about 60%. 北京同仁医院眼肿瘤科赵军阳
Leukocoria is the most presentation in Rb children. When the parents noticed the “white reflex” in children’s pupil, the tumor normally is huge and in late stage. Other presentation include strabismus, glaucoma, etc. Normally the tumor grows and confine in the eyeball at early stage. Metastasis was found at late stage. The tumor can aggress the optic nerve and reach the brain. If the brain was involved, it means this child will die. We found that the optic nerve involved in about 10% of all Rb children in China. As everyone knows, China is a developing country, not all people have the health insurance. It is estimated that only 50% population has health insurance. The system of medical care is different from western country.
Because of these reasons, the enucleation ( remove the eye) is the most popular therapy in China. The first is that over 60% of people live in rural area, many children were in late stage (according to our recordt, about 80%)when they were found had Rb; the second is the most children were paid by their parents, especially from rural, they could not afford the expensive cost, include treatment, transportation and accommodation. Normally the cost for one cycle of chemo need 1,000 US dollar. Most children were removed the affected eyes for saving their life in the past in China, even for some both eyes affected.
There are several hospitals famous for their ophthalmology department, such as Beijing Tong Ren Hospital, Guangdong Zhongshan Ophthalmic Center, Shanghai ENT Center, etc. About 30 to 50 new cases were treated in each hospital. Most ophthalmologists treat Rb alone, not with pediatric oncologist because of some reasons. Even today, only general hospital has both pediatric department and ophthalmology department. Team work is very important in treating Rb; it need ophthalmologist, pediatric oncologist and other doctors collaborate closely. This was only happened in general hospital, such as Beijing Tong Ren Hospital. These doctors must discuss the case together, usually before and after the treatment.
At September of 2006, Beijing Tong Ren Hospital, the most famous for its eye department, set up the first Retinoblastoma Center in China; chemotherapy was widely used in clinic for saving Rb children’s eyes. By now, our center treated over 300 Rb children and saved more than 150 eyes by our endeavor. The center got the strong support from the hospital; there are 3 ophthalmologists and 6 pediatric oncologists in our center. The hospital equipped the center with modern medical instruments in a very short period, such as RetCam, LIO, laser machine, radioactive plaque, even built 3 special rooms for stem cell transplant. We have Rb ward including 38 beds in pediatric department.