幼儿肝母细胞瘤的多学科综合治疗体会  

Multidisciplinary treatment of hepatobastoma in children

作　　者：易为民[1] 钟振东[1] 郭超[1] 杨平洲[1] 厉鸥[1] 谭朝霞[1] 贺湘玲[2] 余阗[3] 祝益民[3] 彭创[1] YI Wei-min;ZHONG Zhen-dong;GUO Chao;YANG Ping-zhou;LI Ou;TAN Zhao-xia;HE Xiang-ling;YU Tian;ZHU Yi-min;PENG Chuang(The 7th ward of Hepatobiliary Surgery,Hunan Provincial People′s Hospital,Changsha 410005,China;Department,Department of Children's Oncology,Hunan Provincial People′s Hospital,Changsha 410005,China;Department of Pediatric Intensive Medicine,Hunan Provincial People′s Hospital,Changsha 410005,China)

机构地区：[1]湖南省人民医院肝胆7病室,湖南长沙410005 [2]湖南省人民医院儿童肿瘤科,湖南长沙410005 [3]湖南省人民医院儿童重症医学科,湖南长沙410005

出　　处：《肝胆胰外科杂志》2018年第2期94-97,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：湖南省科技厅科技计划项目(2009SK3079)

摘　　要：目的探讨多学科协助模式在幼儿肝母细胞瘤诊治中的应用价值。方法回顾性分析2014年4月至2017年5月湖南省人民医院收治的8例经多学科综合诊治的肝母细胞瘤患儿的临床资料。观察指标:(1)治疗前病变范围(PRETEXT)分期、手术情况;(2)病理组织学特点,术后化疗方案;(3)随访患儿中位生存时间、无瘤生存率、总体生存时间。采用门诊和电话方式进行随访。结果 8例患儿均经过多学科讨论,术前PRETEXT分期,Ⅰ期1例,Ⅱ期3例,Ⅲ期3例,Ⅳ期1例;术后病理结果,3例为单纯胎儿型肝母细胞瘤,5例为混合型肝母细胞瘤。术后1个月开始接受顺铂联合多柔比星化疗,共4个周期。随访时间4~40个月,中位随访时间为21.5个月,所有患儿均为无瘤生存。结论根治性手术切除是治疗儿童肝母细胞瘤的基础,多学科综合诊治可为肝母细胞瘤患儿制定个体化治疗方案。Objective To investigate the value of Multi-Disciplinary Team modality in the diagnosis and treatment of hepatobastoma in children.Methods The clinical data of 8 patients with hepatoblastoma treated in Hunan Provincial People's Hospital from Apr.2014 to May 2017 were analyzed retrospectively.Observation indicators:(1)The PRETEXT staging and operation situations;(2)Histopathological features and postoperative chemotherapy protocols;(3)Follow up:median survival time,disease-free survival rate,overall survival time.Patients were followed-up by outpatient examination and telephone interviews.Results All 8 cases underwent multi-disciplinary discussion.The preoperative PRETEXT staging showed 1 case of stage I,3 cases of stage II,3 cases of stage III and 1 case of stage IV.Postoperative pathological examination showed that 3 cases were pure fetal hepatobastoma and 5 cases were mixed type of hepatobastoma.Cisplatin combined with doxorubicin chemotherapy was performed for 4 cycles 1 months after surgery.The patients were followed-up for 4 to 40 months,the median follow-up time was 21.5 months.All patients were disease-free survival.Conclusion Radical resection is the basis of treatment for hepatoblastoma in children.Multi-Disciplinary Team modality can provide a better treatment for children with hepatobastoma.

关 键 词：肝母细胞瘤 多学科协助模式 综合诊治 

分 类 号：R726.1[医药卫生—儿科] R735.7[医药卫生—临床医学]