21例儿童髓母细胞瘤的临床特征及预后分析  

Clinical features and prognosis of 21 children with medulloblastoma

作　　者：支天[1] 张伟令[1] 张谊[1] 黄东生[1] 胡慧敏[1] Zhi Tian;Zhang Weiling;Zhang Yi;Huang Dongsheng;Hu Huimin(Department of Pediatrics,Beijing Tongren Hospital Affiliated to Capital Medical University,Beiiing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院儿科,100176

出　　处：《国际儿科学杂志》2021年第1期68-72,共5页International Journal of Pediatrics

摘　　要：目的探讨髓母细胞瘤(medulloblastoma,MB)患儿的临床特征及辅助化疗效果。方法收集2012年5月至2017年11月首都医科大学附属北京同仁医院儿科收治的21例经病理确诊的MB患儿的临床资料,分析经多学科联合治疗后的临床疗效及预后。结果入组的21例患儿(男15例,女6例;中位年龄6岁3个月)中,肿瘤主要来源于第四脑室(66.7%,14/21例);病理组织分型以经典型最多见(61.9%,13/21例);分子分型中4型居多(47.6%,10/21例);高危组15例(71.4%),余6例(28.6%)低危组患儿均未发生转移(M0期);有16例(76.2%)进行了肿瘤全切除术。随访至2019年12月(中位随访时间29个月),经综合治疗,死亡11例,复发6例,2年生存率为61.5%,5年生存率为51.1%。Cox回归多因素分析显示,肿瘤无播散、放疗与手术的时间间隔短的患儿生存率较高(P<0.05)。结论男童MB发病率高于女童,经典型是MB患儿主要组织病理学亚型。肿瘤有无播散、放疗与手术的时间间隔长短为影响预后的独立危险因素。多学科联合治疗可有效改善远期预后。Objective To investigate the clinical features and adjuvant chemotherapy of children with medulloblastoma(MB).Methods Clinical data of 21 pathologically confirmed MB children admitted to the department of pediatrics of Beijing Tongren Hospital affiliated to Capital Medical University from May 2012 to November 2017 were collected to analyze the clinical efficacy and prognosis of multidisciplinary combined treatment.Results There were 21 children enrolled in the study(15 males and 6 females;median age:6 years and 3 months).The majority of tumors were from the fourth ventricle(66.7%,14/21 cases).The most common type of pathological tissue was classic medulloblastoma(61.9%,13/21 cases).Most of the molecular types was type 4(47.6%,10/21 cases).There were 15 cases(71.4%)in the high-risk group and the remaining 6 cases(28.6%)in the low-risk group without metastasis(M0 stage).Total tumor resection was performed in 16 cases(76.2%).The patients were followed up to December 2019(median follow-up time was 29 months).After comprehensive treatment,11 patients died and 6 patients relapsed.The 2-year survival rate was 61.5%,and the 5-year survival rate was 51.1%.Cox regression multivariate analysis showed that the survival rate of children with no tumor spread,short time interval between radiotherapy and surgery was higher(P<0.05).Conclusion The incidence of MB in boys is higher than that in girls.Whether the tumor is disseminated or not,the time interval between radiotherapy and surgery are independent risk factor affecting the prognosis.Multidisciplinary combination therapy can effectively improve the long-term prognosis.

关 键 词：儿童 髓母细胞瘤 化疗 预后 

分 类 号：R739.4[医药卫生—肿瘤]