临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
5期
410-412
,共3页
潘慈%张安安%叶启东%周敏%薛惠良%陈静%罗长缨%沈树红%王坚敏%汤燕静%汤静燕
潘慈%張安安%葉啟東%週敏%薛惠良%陳靜%囉長纓%瀋樹紅%王堅敏%湯燕靜%湯靜燕
반자%장안안%협계동%주민%설혜량%진정%라장영%침수홍%왕견민%탕연정%탕정연
神经母细胞瘤%治疗%预后%儿童
神經母細胞瘤%治療%預後%兒童
신경모세포류%치료%예후%인동
neuroblastoma%therapy%prognosis%children
目的:分析1、2期神经母细胞瘤(NB)的临床特征、诊疗方案及远期疗效,为进一步改进治疗方案提供循证依据。方法回顾性分析1998年6月至2010年12月初诊并接受治疗的神经母细胞瘤1、2期患儿的临床资料。结果 NB患儿237例,1期24例,2期25例,1、2期患儿占所有NB患儿的20.7%(49/237)。诊断时的中位年龄25个月(2周~9岁),男29例,女20例。31例(63.6%)患儿因体检或影像学检查意外发现肿块。原发部位以后纵隔和腹部多见,分别为21例(42.9%)、22例(44.9%)。病理类型为预后良好者40例(81.6%)。尿香草苦杏仁酸(VMA)正常者32例(91.4%)。进行检测的患儿血LDH升高均不到正常值5倍。N-MYC扩增1例。10例患儿进入低危组治疗,仅行手术治疗。39例患儿进入中危组治疗,进行了手术及化疗综合治疗。所有49例患儿治疗结束时均获得非常好的部分缓解(VGPR),中位随访时间为60个月(22~148个月),未满5年失访者9例,中位随访时间为3个月(1~32个月)。全组2年、3年、5年无事件生存率(EFS)及生存率(OS)均为100%。结论1、2期神经母细胞瘤预后良好,应进一步减少化疗强度和时间。
目的:分析1、2期神經母細胞瘤(NB)的臨床特徵、診療方案及遠期療效,為進一步改進治療方案提供循證依據。方法迴顧性分析1998年6月至2010年12月初診併接受治療的神經母細胞瘤1、2期患兒的臨床資料。結果 NB患兒237例,1期24例,2期25例,1、2期患兒佔所有NB患兒的20.7%(49/237)。診斷時的中位年齡25箇月(2週~9歲),男29例,女20例。31例(63.6%)患兒因體檢或影像學檢查意外髮現腫塊。原髮部位以後縱隔和腹部多見,分彆為21例(42.9%)、22例(44.9%)。病理類型為預後良好者40例(81.6%)。尿香草苦杏仁痠(VMA)正常者32例(91.4%)。進行檢測的患兒血LDH升高均不到正常值5倍。N-MYC擴增1例。10例患兒進入低危組治療,僅行手術治療。39例患兒進入中危組治療,進行瞭手術及化療綜閤治療。所有49例患兒治療結束時均穫得非常好的部分緩解(VGPR),中位隨訪時間為60箇月(22~148箇月),未滿5年失訪者9例,中位隨訪時間為3箇月(1~32箇月)。全組2年、3年、5年無事件生存率(EFS)及生存率(OS)均為100%。結論1、2期神經母細胞瘤預後良好,應進一步減少化療彊度和時間。
목적:분석1、2기신경모세포류(NB)적림상특정、진료방안급원기료효,위진일보개진치료방안제공순증의거。방법회고성분석1998년6월지2010년12월초진병접수치료적신경모세포류1、2기환인적림상자료。결과 NB환인237례,1기24례,2기25례,1、2기환인점소유NB환인적20.7%(49/237)。진단시적중위년령25개월(2주~9세),남29례,녀20례。31례(63.6%)환인인체검혹영상학검사의외발현종괴。원발부위이후종격화복부다견,분별위21례(42.9%)、22례(44.9%)。병리류형위예후량호자40례(81.6%)。뇨향초고행인산(VMA)정상자32례(91.4%)。진행검측적환인혈LDH승고균불도정상치5배。N-MYC확증1례。10례환인진입저위조치료,부행수술치료。39례환인진입중위조치료,진행료수술급화료종합치료。소유49례환인치료결속시균획득비상호적부분완해(VGPR),중위수방시간위60개월(22~148개월),미만5년실방자9례,중위수방시간위3개월(1~32개월)。전조2년、3년、5년무사건생존솔(EFS)급생존솔(OS)균위100%。결론1、2기신경모세포류예후량호,응진일보감소화료강도화시간。
Objectives To evaluate the clinical features, treatment scheme and long-term outcomes of stage 1、2 childhood neuroblastoma (NB). Methods The retrospective study included 49 newly diagnosed NB stage 1、2 patients from June 1998 to December 2010. Clinical data and long-term outcomes were analyzed. Results Twenty-four patients with stage 1 NB and twenty patients with stage 2 NB were found among all 237 patients with NB enrolled in this study. The median age at diagnosis was 25 months( 2 week to 9 year old),29 males and 20 females. Thirty-one patients (63.6%) without symptoms were discovered with tumor by physical or imaging examination. Thorax and abdomen were the most common sites of primary tumor (21 and 22 cases, accounting for 42.9% and 44.9% of all patients, respectively). Forty (81.6%) NB patients had favorable pathology classification. One patient was of MYCN amplification status. Urine vanilla mandelic acid was normal in 32 (91.4%) patients, and serum lactate dehydrogenase was less than five times of the normal value in all patients. Ten NB patients were treated ac-cording to the low-risk protocol who received surgery alone.Thirty-nine patients were treated according to intermediate-risk protocol who received both surgery and chemotherapy. All the patients achieved very good partial remission (100%).The medi-an follow-up period was 60 months(22 months to148months). Nine patients were lost after a follow up of 3 months in medi-an. The 2-、3-、5-year event free survival and overall survial of all 49 patients was 100%. Conclusions The prognosis for neu-roblastoma of stage 1、2 in this study was with 100%survival, which provides opportunity for further reduction of dosage and/or duration of episodes in chemotherapy.