肾母细胞瘤手术前介入治疗的疗效评价  

Preoperative interventional therapy in management of nephroblastoma

作　　者：李家平[1] 杨建勇[1] 李桂生[2] 陈伟[1] 庄文权[1] 李智[3] 鲁建生[4] 周欣[5] 

机构地区：[1]中山医科大学附属第一医院介入放射科,广州510080 [2]中山医科大学附属第一医院外科,广州510080 [3]中山医科大学附属第一医院病理科,广州510080 [4]武汉儿童医院病理科 [5]武汉儿童医院外科

出　　处：《中华小儿外科杂志》2002年第2期103-105,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　评价肾母细胞瘤术前介入性肾动脉栓塞化疗的可行性及疗效。方法　观察分析17例肾母细胞瘤患儿TACE前后临床症状的变化及反应 ,同时与 2 2例单纯手术者比较术中情况和远期疗效。观察指标有 ,肿瘤体积 ,术中情况 ,肿瘤切除。结果　TACE后肿瘤平均缩小 4 1.7%。,总有效率 76 .5 % (13/17) ;术前介入组肿瘤完全切除率、术中平均出血量、肿瘤坏死区域面积分别为 :10 0 %、(14 2 .2± 73.2 )ml、6 0 .0 % ,单纯手术组分别为 6 3.6 %、(2 5 8.2± 2 14 .4 )ml、15 .0 % ;术前介入组 15例 (15 /17)获随访 ,2年无瘤生存率 73.3% (11/15 ) ;单纯手术组 14例 (14 /2 2 )获随访 ,2年无瘤生存率 4 2 .9% (6 /14 )。结论　肾母细胞瘤TACE ,能有效杀死肿瘤细胞 ,控制肿瘤生长 ,提高肿瘤完整切除率 ,改善预后 ,无严重并发症 。Objective To evaluate the efficacy of preoperative transarterial chemoembolization(TACE) in the management of nephroblastoma.Methods The progress of 17 nephroblastoma patients who underwent combined TACE and surgery was compared to that of 22 patients with resection alone. Results Tumour shrinkage (by 47.1% in volume) was observed on 12 patients ( 64.7% ) of the TACE group. Radical resection was performed on all cases of TACE and 63.6% of the control group. Blood loss ( 142.2 ± 73.2 ?ml) in TACE group was less than that of the control ( 258.2 ± 214.4 ?ml). The mean area of tumour necrosis was 60.0% in TACE group and 15.0% in the control. The two year event free rate was 70.6% (15/17) in TACE and 45.4% (14/22) in the control group separately.Conclusions Preoperative TACE is effective in inducing massive tumour necrosis. The clinical response is encouraging while no major complications are encountered. This improves the survival rate of nephroblastoma.

关 键 词：肾母细胞瘤 介入性治疗 手术前 治疗 疗效评价 

分 类 号：R737.11[医药卫生—肿瘤] R730.5[医药卫生—临床医学]