多学科单中心CCCG-HB-2016方案治疗儿童肝母细胞瘤疗效分析  

A CCCG-HB-2016 regimen in the treatment of hepatoblastoma in children

作　　者：汤文芳 卿宜 沈贤波[2] 贺湘玲[1] 黄怀银 朱呈光[1] 陈可可[1] 田鑫[1] 邹润英[1] 彭创[2] 陈志鸿[3] 毛志群[4] 赵康[5] Tang Wenfang;Qing Yi;Shen Xianbo;He Xiangling;Huang Huaiyin;Zhu Chengguang;Chen Keke;Tian Xin;Zou Runying;Peng Chuang;Chen Zhihong;Mao Zhiqun;Zhao Kang(Department of Pediatrics,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410011,China;Department of Hepatobiliary Surgery,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410011,China;Department of Pathology,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410011,China;Department of Radiology,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410011,China;Department of Ultrasound,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410011,China)

机构地区：[1]湖南省人民医院/湖南师范大学附属第一医院儿童医学中心,长沙410011 [2]湖南省人民医院/湖南师范大学附属第一医院肝胆外科,长沙410011 [3]湖南省人民医院/湖南师范大学附属第一医院病理科,长沙410011 [4]湖南省人民医院/湖南师范大学附属第一医院放射科,长沙410011 [5]湖南省人民医院/湖南师范大学附属第一医院超声科,长沙410011

出　　处：《中华普通外科杂志》2021年第5期332-336,共5页Chinese Journal of General Surgery

基　　金：湖南省科技厅重点研发项目(2018SK21216)。

摘　　要：目的:评估采用多学科单中心CCCG-HB-2016方案治疗儿童肝母细胞瘤(HB)的临床疗效,分析此方案在临床上的可行性及安全性。方法:前瞻性研究本院2016年8月~2020年3月确诊的36例HB患儿多学科CCCG-HB-2016方案治疗的临床疗效。结果:36例患儿中男20例,女16例。患儿AFP均增高,范围为2792~2253000 ng/ml,AFP与肿瘤危险度分层之间差异有统计学意义(H=14.973,P<0.05)。病理分型包括上皮型、上皮-间叶混合型,以上皮型多见,分别为28例(77.78%)、8例(22.22%)。肿瘤危险度分层与手术切除肝叶之间差异有统计学意义(H=8.847,P<0.05)。化疗不良反应主要为骨髓抑制,低、中、高危组骨髓抑制发生率分别为58.33%(35/60)、73.49%(61/83)、80.23%(69/86)。随访至2020年3月底,中位随访时间21.9个月,中位生存期为22.5个月,总生存率(OS)为97.2%,无事件生存率(EFS)为83.3%。结论:多学科CCCG-HB-2016方案治疗后手术成功率高,术后化疗不良反应以骨髓抑制多见,有较好的可行性、安全性。Objective To evaluate the clinical efficacy of multi-disciplinary single center's CCCG-HB-2016 regimen in the treatment of hepatoblastoma(HB)in children.Methods Clinical data of 36 HB patients treated with CCCG-HB-2016 program from Aug 2016 to March 2020 were analyzed.Results These 36 patients included 20 boys and 16 girls.The serum AFP was all higher than 2792 ng/ml,there was a correlation between AFP and tumor risk stratification(H=14.973,P<0.05).Twenty eight cases(77.78%)were epithelial type and 8 cases(22.22%)were mixed epithelial mesenchymal type.All children were treated by tumor resection combined with chemotherapy,and there was a correlation between tumor risk stratification and surgical resection of liver lobe(H=8.847,P<0.05).The probability of bone marrow suppression in the low-risk group was 58.33%(35/60),that in the intermediate-risk group was 73.49%(61/83)and in the high-risk group was 80.23%(69/86).All 36 cases were followed up to March 31,2020,with an average follow-up of 21.9 months and the median survival was 22.5 months.The overall survival rate(OS)and event-free survival rate(EFS)were 97.2%and 83.3%respectively.Conclusions The multidisciplinary CCCG-HB-2016 regimen was with a high success rate and along with a high incidence of bone marrow suppression.

关 键 词：肝胚细胞瘤 甲胎蛋白类 化疗 手术治疗 

分 类 号：R735.7[医药卫生—肿瘤]