儿童髓母细胞瘤继发第二肿瘤的临床特点分析  

Clinical analysis of medulloblastoma with secondary tumors in children

作　　者：刘妍 杜淑旭[1] 孙艳玲[1] 张金[1] 武万水[1] 孙黎明[1] LIU Yan;DU Shuxu;SUN Yanling;ZHANG Jin;WU Wanshui;SUN Liming(Department of Pediatrics,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院儿科,北京100038

出　　处：《中国小儿血液与肿瘤杂志》2022年第5期305-309,共5页Journal of China Pediatric Blood and Cancer

摘　　要：目的分析儿童髓母细胞瘤继发第二肿瘤的发病情况、临床特点及预后。方法2012年03月—2019年9月共收治髓母细胞瘤患儿637例,其中7例(男5例,女2例)出现了第二肿瘤,回顾性分析其起病年龄、病理及分子分型、出现第二肿瘤的时间及类型、治疗及预后情况。结果截至2022年3月,中位随访时间39(17~67)个月,第二肿瘤发病率约为1.1%。确诊时的中位年龄为7.3(4~11)岁,出现第二肿瘤的中位年龄为10.8(5~15)岁。第二肿瘤发生在术后的中位时间为3(1~10)年,类型为胶质母细胞瘤(2例)、骨髓增生异常综合征(2例)、急性白血病(1例)、恶性纤维组织瘤(1例)和神经纤维瘤(1例)。第二肿瘤患儿部分接受化学治疗,4例死亡,3例存活。结论髓母细胞瘤患儿第二肿瘤的发生率低,但随访时间延长亦随之增高,应加强随访及定期监测。Objective To analyze the incidence,clinical characteristics and prognosis of secondary tumors in childhood medulloblastoma.Methods Among 637 medulloblastoma patients(from April 2012 to April 2019)7 patients(5 males and 2 females)with secondary tumors were found and analyzed retrospectively,including age of onset,pathological and molecular typing,time and type of secondary tumors,treatment and prognosis.Results Up to March 2022,the median follow-up time was 39(17-67)months.Seven cases were diagnosed with secondary tumors and the incidence rate was about 1.1%.The median age of medulloblastoma was 7.3(4-11)years and the time of secondary tumors was 10.8(5-15)years.Secondary tumors occurred from 1 year to 10 years after operation,with the median time of 3 years,including glioblastoma(2 cases),myelodysplastic syndrome(2 cases),acute leukemia(1 case),malignant fibrous histioca(1 case)and neurofibroma(1 case).Most of patients were treated with palliative treatment,while few of them were treated with chemotherapy,4 cases died and 3 cases survived.Conclusions The incidence of secondary tumors in children with medulloblastoma is very low,but the incidence increases with the extension of follow-up time.Longtime follow up and regular monitoring should be strengthened.

关 键 词：髓母细胞瘤 儿童 第二肿瘤 

分 类 号：R739.41[医药卫生—肿瘤]