榄香烯联合化疗治疗儿童肝母细胞瘤伴肺转移的临床疗效  

Clinical efficacy of elemene combined with chemotherapy in the treatment of hepatoblastoma with lung metastasis in children

作　　者：支天[1] 张伟令[1] 张谊[1] 刘婷婷 李颂 陈末伊 黄东生[1] Zhi Tian;Zhang Weiing;Zhang Yi;Liu Tingting;Li Song;Chen Moyi;Huang Dongsheng(Department of Beijing Tongren Hospital Affiliated to Capital Medical University,Beiling 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院儿科,北京100176

出　　处：《中国医学前沿杂志（电子版）》2023年第8期38-42,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨榄香烯联合化疗治疗儿童肝母细胞瘤伴肺转移的临床疗效及安全性。方法回顾性分析首都医科大学附属北京同仁医院儿科单中心2017年1月到2021年12月收治的经病理和影像学确诊的肝母细胞瘤伴肺转移的患儿83例(中位年龄3.75岁),随机分为对照组和观察组,其中40例采取化疗的患儿作为对照组,另43例在对照组的基础上加用榄香烯乳状注射液治疗的患儿为观察组。所有患儿治疗结束后定期随访,进行两组临床疗效及药物安全性的比较。结果①观察组生存率为90.7%、治疗有效率为69.7%;而对照组的生存率为82.5%、治疗有效率为45.0%,治疗有效率差异有统计学意义(χ^(2)=4.247,P=0.039)。②随访至2022年6月,观察组的1年、2年、3年总生存率分别为95.0%、90.7%、85.0%,与对照组比较(1年、2年、3年总生存率分别为94.7%、88.2%、79.1%),无统计学差异(χ^(2)=1.809,P=0.179);观察组1年、2年、3年的无事件生存率分别为95.1%、90.6%、83.6%,与对照组比较(1年、2年、3年的无事件生存率分别为91.9%、73.7%、49.1%),二者差异有统计学意义(χ^(2)=4.482,P=0.034)。③两组的不良反应主要表现为化疗后骨髓抑制,其次为胃肠道反应及肝肾功能异常,多为I~II级轻微不良反应,两组比较无统计学差异(均P>0.05);观察组应用榄香烯后发热、注射部位疼痛等症状少见,且未出现静脉炎、过敏等不良反应。两组治疗前、治疗后的身长、体重均呈上升趋势,不同时间点两组身长和体重比较差异无统计学意义(P>0.05)。结论榄香烯合化疗治疗儿童肝母细胞瘤伴肺转移能够提高治疗有效率、改善预后,且不良反应较少,对生长发育影响小。Objective To investigate the clinical efficacy and safety of elemene combined with chemotherapy in the treatment of hepatoblastoma with lung metastasis in children.Methods From January 2017 to December 2021,83 children(median age 3.75 years)with hepatoblastoma with lung metastasis diagnosed by pathology and imaging in the single Center of Pediatrics of Beijing Tongren Hospital Affiliated to Capital Medical University were retrospectively analyzed.The children were randomly divided into control group and observation group,in which 40 children who took chemotherapy as the control group and the other 43 children who were treated with elecampane emulsion injection on top of chemotherapy as the observation group.All children were followed up regularly to compare the clinical efficacy and drug safety between the two groups.Results O In the observation group,the survival rate was 90.7%and the effective rate was 69.7%.The survival rate and effective rate of the treatment group were 82.5%and 45.0%,lower than those of the observation group.The effective rates were significantly different between the two groups(χ^(2)=4.247,P=0.039).@At follow-up until June 2022,the overall survival rates at 1,2,and 3 years in the observation group were 95.0%,90.7%and 85.0%,respectively,compared with the control group(94.7%,88.2%and 79.1%,respectively),and there was no significant difference(χ^(2)=1.809,P=0.179).The 1-year,2-year and 3-year event-free survival(EFS)of the observation group were 95.1%,90.6%and 83.6%,respectively,compared with those of the control group(91.9%,73.7%and 49.1%,respectively),and there was significant statistical difference between them(χ^(2)=4.482,P=0.034).The main adverse reactions of the two groups were bone marrow suppression after chemotherapy,followed by gastrointestinal reactions and abnormal liver and kidney function,most of which were grade I~II mild adverse reactions.There was no significant difference between the two groups(all P<0.05);In the observation group,fever,injection site pain and other sympto

关 键 词：榄香烯 化疗 儿童 肝母细胞瘤 肺转移 临床疗效 

分 类 号：R735.7[医药卫生—肿瘤]