Retinoblastoma in China Junyang Zhao _36503 by heku


									?Oncology, Beijing, Tongren hospital carried, Zhao Yang

?Retinoblastoma in China Junyang


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%.
Ocular Oncology Zhao Yang in Beijing

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

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.

?Oncology, Beijing, Tongren hospital carried, Zhao Yang

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