天津医药

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儿童Ⅳ期神经母细胞瘤手术疗效的效果分析

李忠元,赵强,王景福,曹嫣娜,李璋琳,闫杰   

  1. 天津医科大学附属肿瘤医院
  • 收稿日期:2010-10-13 修回日期:2010-12-22 出版日期:2011-04-15 发布日期:2011-04-15
  • 通讯作者: 李忠元

The Effect of Surgical Treatment in Children with Stage Ⅳ Neuroblastoma

  • Received:2010-10-13 Revised:2010-12-22 Published:2011-04-15 Online:2011-04-15
  • Contact: LI Zhong Yuan

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摘要： 目的：总结48例Ⅳ期儿童神经母细胞瘤手术、化疗、放疗综合?治疗的资料，分析手术对儿童Ⅳ期神经母细胞瘤的疗效。方法：回顾性分析1995年6月至2009年6月天津医科大学附属肿瘤医院收治的并且随访资料完整的48例Ⅳ期神经母细胞瘤患儿手术治疗的情况，其中男31例，女17例，根据年龄将患儿分为中危组和高危组，进入中危组10例，高危组38例。综合治疗为根据不同组别采用不同强度方案化疗、外科手术切除原发肿瘤及局部瘤床放疗等。结果：全组患者随访2个月～110个月，38例原发灶完全切除患者中位生存时间27.5个月，10例原发灶未完全切除患者中位生存时间23.5个月，两者比较经Log-rank检验差异无统计学意义（P＞0.05）；原发灶是否完全切除对Ⅳ期神经母细胞瘤患儿CR、肿瘤复发和存活的影响经卡方检验差异亦无统计学意义（均P＞0.05）。结论：Ⅳ期神经母细胞瘤应采取手术、放疗及化疗为主的综合治疗，手术完全切除原发肿瘤对患者达CR、肿瘤复发及存活无明显影响。因此，手术发挥的作用建立在对肿瘤转移灶控制治疗不断提高的基础上。

关键词: 神经母细胞瘤, 儿童, 外科手术

Abstract: Objective: To summarize our data of surgical treatment, chemotherapy and radiotherapy for 48 cases of children with stage Ⅳ neuroblastoma, who with complete followed-up , further to investigate the effect of surgical treatment in the combined management for children with Ⅳ neuroblastoma. Methods: Form June 1995 to June 2009, 48 cases with stage Ⅳ neuroblastoma in our hospital were enrolled in this study, including 31 boys and 17 girls , who were divided into medium and high risk groups ( 10 and 38 cases for each group ) according to their age of onset. The comprehensive protocol included delayed tumor resection , intensive chemotherapy mainly composed of multiple cytotoxic drugs and local radiotherapy and so on. Results: After a follow-up ( range 2 to 110 months )，the 38 patients who underwent complete tumor resection ,had the median survival of 27.5 months. And the median survival of 10 patients who underwent partial tumor resection was 23.5 months. No significant difference was noted between them(P＞0.05). And we found no significant difference in the CR rate ,relapse rate and survival condition between two groups (P＞0.05). Conclusions: stage Ⅳ neuroblastoma should be taken combined therapy, including surgery, radiotherapy and chemotherapy , complete primary tumor resection has no significant effect on the CR rate and relapse rate and survival condition , thus the prognosis of patients with stage Ⅳ neuroblastoma undergoing surgical treatment depends on the effect of chemotherapeutics which inhibits the metastasis.

Key words: Neuroblastoma, Children, Surgical resection