青春期女性颅外实体肿瘤患儿临床特征及生长发育情况的单中心研究  

A single-center study of clinical characteristics and growth and development of children with extracranial solid tumors in adolescent females

作　　者：方梓莳 苏雁[1] 简冰林 赵文[1] 段超[1] 王希思[1] 金眉[1] 马晓莉[1] FANG Zishi;SU Yan;JIAN Binglin;ZHAO Wen;DUAN Chao;WANG Xisi;JIN Mei;MA Xiaoli(Department of Medical Oncology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院肿瘤内科,北京100045

出　　处：《中国研究型医院》2025年第1期26-33,共8页Chinese Research Hospitals

基　　金：北京市研究型病房项目(BCR202101);北京市自然科学基金(7222054)。

摘　　要：目的探讨青春期女性颅外实体肿瘤患儿临床特征、预后及其生长发育情况,为提高此类患儿的治疗和管理水平提供数据支持。方法研究纳入2010年1月—2021年12月,于首都医科大学附属北京儿童医院肿瘤内科系统诊治的,已有第二性征发育或年龄≥13岁且<18岁的女性颅外新发实体肿瘤患儿。对其进行临床特征及预后回顾性分析,并对存活患儿的生长发育情况进行随访。随访指标包括患儿原发肿瘤活动情况、生存情况、生长发育情况、心脏功能及运动耐量。采用Kaplan-Meier方法进行生存分析。应用SPSS统计学软件进行数据处理。正态分布的计量资料用xˉ±s表示,两组比较采用t检验;非正态分布的计量资料以M(Q1,Q3)表示,采用U检验;计数资料以例(%)表示,组间比较采用χ^(2)检验;P<0.05为差异有统计学意义。结果共纳入64例患儿,患儿的肿瘤类型以横纹肌肉瘤(RMS)(16例,占25.0%)及尤因肉瘤为主(ES)(16例,占25.0%)为主,其余依次为非横纹肌软组织肉瘤(NRSTS)、神经母细胞瘤、骨肉瘤及其他类型肿瘤。确诊时患儿年龄10.0~17.6岁、平均(12.2±1.7)岁,中位病程4.2(1.3,6.2)个月。中位随访时间为41.0(13.2,49.4)个月,所有患者5年无事件生存率及总生存率分别为48.2%和58.0%。对39例存活患儿进行生长发育的随访调查。截止末次随访时,末次随访中位年龄为15.5(14.5,17.2)岁,身高153.2~181.0 cm,平均(165.2±5.4)cm,体质量40.0~90.0 kg,平均(54.9±12.0)kg。其中10例(25.6%)患儿消瘦,无患儿身高生长迟缓;5例(12.8%)患儿青春期发育延迟;15例(38.5%)患儿月经周期不稳定;19例(55.9%)患儿运动耐量减低。结论青春期颅外实体肿瘤女性患儿疾病谱以软组织肉瘤为主,中位病程较长,总体预后较差。抗肿瘤治疗后可能出现消瘦、月经紊乱、青春期发育延迟及运动耐量降低等问题,应引起重视。Objective To explore the clinical characteristics,prognosis and their growth and development of adolescent female children with extracranial solid tumors,and to provide data to support the improvement of the treatment and management of such children.Methods From January 2010 to December 2021,children with new extracranial solid tumors in adolescent females who had developed secondary sexual characteristics or were≥13 years old and<18 years old,and who were diagnosed and treated at the Department of Medical Oncology of Beijing Children's Hospital,Capital Medical University,were enrolled in the study.The clinical characteristics and prognosis of the children were retrospectively analyzed,and the growth and development of the surviving children were followed up.Follow-up indicators included primary tumor activity,survival,growth and development,cardiac function and exercise tolerance.The Kaplan-Meier method was used for survival analysis.SPSS statistical software was applied for data processing.Normally distributed measurements were expressed as xˉ±s,and t-test was used to compare the two groups;non-normally distributed measurements were expressed as M(Q1,Q3),and U-test was used;counting data were expressed as cases(%),andχ^(2)-test was used to compare the groups;P<0.05 was considered as the difference was statistically significant.Results A total of 64 children were included.The tumor types of the children were mainly rhabdomyosarcoma(RMS)(16 cases,25.0%)and ewing's sarcoma predominantly(ES)(16 cases,25.0%),and the rest were non-rhabdomyosarcoma soft tissue sarcoma(NRSTS),neuroblastoma,osteosarcoma,and other types of tumors in that order.At the time of diagnosis,children were aged 10.0-17.6 years,mean(12.2±1.7)years,with a median disease duration of 4.2(1.3,6.2)months.The median follow-up was 41.0(13.2,49.4)months,and the 5 year event-free and overall survival rates for all patients were 48.2%and 58.0%,respectively.Follow-up investigations of growth and development were performed in 39 surviving children.By t

关 键 词：女性 青春期发育 颅外实体肿瘤 临床特征 

分 类 号：R73[医药卫生—肿瘤]