儿童肝母细胞瘤综合治疗27例疗效探讨  

Therapeutic efficacy evaluation for 27 children with hepatoblastoma

作　　者：乔晓红[1] 赵强[1] 胡月[1] 王景福[1] 闰杰[1] 李璋琳[1] 曹嫣娜[1] 李杰[1] 王会娟[1] 

机构地区：[1]天津医科大学附属肿瘤医院儿童肿瘤科、天津市“肿瘤防治”重点实验室,300060

出　　处：《中华小儿外科杂志》2012年第9期647-650,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的总结我院治疗儿童肝母细胞瘤的经验。方法回顾性分析2000年6月至2007年1月经病理证实的27例肝母细胞瘤患儿的临床及随访资料。结果本组按国际儿童肿瘤协会（SIOP）PRETEXT分期：Ⅰ期3例，Ⅱ期10例，Ⅲ期11例，Ⅳ期3例。本组采用手术联合化疗的综合治疗措施，其中Ⅰ期手术3例，Ⅱ期手术24例。治疗后获得完全缓解22例，获得部分缓解2例，疾病进展2例，于术后化疗中死亡1例。至随访结束，20例无病生存，4例死于肿瘤复发，2例死于进展。27例的5年生存率为74．1％。结论联合术前化疗后肿瘤可完全切除的肝母细胞瘤患儿可长期生存，而化疗后手术仍无法切除或治疗后复发的患儿的预后较差。Objective To summarize the therapeutic efficacy evaluation for children with hepatoblastoma. Methods Between June 2000 and January 2007, total 27 patients with hepatoblastoma underwent treatment in out center and histological report confirmed clinical diagnosis. In this study the clinical data and follow-up outcome were retrospectively analyzed. Results The SIOP PRETEXT staging criteria was used in this study, among all patients 3 cases were diagnosed as PRETEXT Ⅰ , 10 caes as PRETEXT Ⅱ , 11 cases as PRETEXT Ⅲ, and 3 cases as PRETEXT Ⅳ respectively. All patients were treated with multidisciplinary approaches involving surgery combined with chemotherapy. 3 patients underwent one-stage operation without preoperative chemotherapy, while 24 patients underwent preoperative chemotherapy before surgery. Afterwards, 22 patients of all achieved complete re- mission, 2 reached partial remission,2 patients were still in progression, and 1 patient died during the period of postoperative chemotherapy. By the end of follow-up, 20 patients had a disease-free-survival, while 4 patients died due to recurrences and 2 died from progression. The overall 5 year survival rate was 74. 1%. Conclusions Patients with complete resection after chemotherapy survive well, while for those without completion resection after chemotherapy or with recurrence, will encounter a poor prognosis.

关 键 词：癌 肝细胞 儿童 综合疗法 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]