儿童晚期肝母细胞瘤综合治疗的疗效观察  

Comprehensive treatment of advanced hepatoblastoma in children and observation of its clinical efficacy

作　　者：张伟令[1] 张谊[1] 黄东生[1] 洪亮[1] 王一卓[1] 朱霞[1] 胡慧敏[1] 张品伟[1] 易优[1] 韩涛[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科,100176

出　　处：《中华实用儿科临床杂志》2013年第7期521-524,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：北京科委首都临床特色资助项目（D101100050010052）

摘　　要：目的总结晚期肝母细胞瘤（HB）患儿的临床治疗结果，探讨晚期HB的临床疗效及诊疗经验。方法回顾性分析2006年4月至2012年8月北京同仁医院儿科收治的40例经病理确诊及分期明确的晚期HB患儿（男29例，女11例；发病年龄3个月～11岁6个月，中位年龄1．9岁）的病例资料，根据美国儿童肿瘤组织肝母细胞瘤国际分期分为Ⅲ期15例，Ⅳ期25例，采用多科室协作模式进行治疗。结果随访至2012年8月，中位随访时间为21个月（1～67个月），失访1例，余39例患儿获随访，死亡12例（其中1例为进展期放弃治疗死亡，1例化疗中合并脏器衰竭死亡），完全缓解及部分缓解共27例（其中1例为进展期放弃治疗至随访日仍存活），总生存率为69．2％（27／39例）。结论晚期HB儿童一旦伴有远处组织器官转移预后较差，但综合治疗仍可延长患儿生存期及提高临床缓解率。Objective To study clinical efficacy of advanced hepatoblastoma （HB） treatment in children by summing up the clinical data in Beijing Tongren Hospital. Methods Clinical data from 40 children with advanced HB were analyzed retrospectively, who were pathologically confirmed and clearly staged from Apr. 2006 to Aug. 2012 in Beijing Tongren Hospital. They were 29 male and 11 female. The medium age was 1.9 years old （ 3 months - 11.6 years old）. According to international staging system for HB from American Pediatric Ontology Group, 15 cases were in stage II1 and 25 cases were in stage IV. The clinical co-therapy involved multiple departments. Results Through 21-month follow-up on the average until Aug. 2012 （1 to 67 months） ,39 patients received follow-up and 1 case missed follow-up; 27 patients reached complete or partial remission（ in which 1 case gave up treatment in the progressive stage, but still alive when followed up） ,with overall survival rate of 69.2% （27/39 cases） ;12 patients died, among them 1 case gave up treatment in the progressive stage, and 1 case died from complications of multiple organ failures during chemotherapy. Conclusions Although the prognosis of advanced HB with distal organ metastasis in children is usually poor,it is still possible for the patients to have a long-term survival with combined therapies and increase clinical remission rate.

关 键 词：肝母细胞瘤 化疗 放疗 介入治疗 儿童 

分 类 号：R735.7[医药卫生—肿瘤]