中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2014年
24期
1568-1572
,共5页
李鹏飞%刘均澄%甄子俊%刘卓炜%高远红%朱佳%王娟%路素英%孙斐斐%张飞%蔡瑞卿%郭晓芳%孙晓非
李鵬飛%劉均澄%甄子俊%劉卓煒%高遠紅%硃佳%王娟%路素英%孫斐斐%張飛%蔡瑞卿%郭曉芳%孫曉非
리붕비%류균징%견자준%류탁위%고원홍%주가%왕연%로소영%손비비%장비%채서경%곽효방%손효비
神经母细胞瘤%4期%手术%生存率%切除率
神經母細胞瘤%4期%手術%生存率%切除率
신경모세포류%4기%수술%생존솔%절제솔
neuroblastoma%stage IV%surgery%survival rate%extent of surgical resection
目的：探讨4期神经母细胞瘤（neuroblstoma，NB）原发肿瘤手术切除程度与生存率的关系，分析不同手术切除程度对预后的影响。方法：回顾分析2000年1月至2011年12月中山大学肿瘤防治中心收治的96例4期NB患者临床资料。根据原发灶手术切除程度将患者分为：A组：未手术或仅活检或手术切除<50%的原发肿瘤；B组：手术切除50%～90%的原发肿瘤；C组：手术切除>90%的原发肿瘤；D组：手术肉眼完全切除原发肿瘤。结果：96例4期NB患者，3年PFS和OS分别为32.8%和36.7%。A组24例，B组10例，C组23例，D组39例。A组和B组间PFS比较差异无统计学意义（P=0.352），C组和D组间PFS比较差异无统计学意义（P=0.792）。但C组+D组生存率高于A组+B组，3年PFS分别为42.2%和17.8%（P <0.001）。结论：4期NB原发肿瘤90%以上完全切除联合化疗和（或）放疗可提高生存率，少量肉眼残留或镜下残留并不影响生存率。
目的：探討4期神經母細胞瘤（neuroblstoma，NB）原髮腫瘤手術切除程度與生存率的關繫，分析不同手術切除程度對預後的影響。方法：迴顧分析2000年1月至2011年12月中山大學腫瘤防治中心收治的96例4期NB患者臨床資料。根據原髮竈手術切除程度將患者分為：A組：未手術或僅活檢或手術切除<50%的原髮腫瘤；B組：手術切除50%～90%的原髮腫瘤；C組：手術切除>90%的原髮腫瘤；D組：手術肉眼完全切除原髮腫瘤。結果：96例4期NB患者，3年PFS和OS分彆為32.8%和36.7%。A組24例，B組10例，C組23例，D組39例。A組和B組間PFS比較差異無統計學意義（P=0.352），C組和D組間PFS比較差異無統計學意義（P=0.792）。但C組+D組生存率高于A組+B組，3年PFS分彆為42.2%和17.8%（P <0.001）。結論：4期NB原髮腫瘤90%以上完全切除聯閤化療和（或）放療可提高生存率，少量肉眼殘留或鏡下殘留併不影響生存率。
목적：탐토4기신경모세포류（neuroblstoma，NB）원발종류수술절제정도여생존솔적관계，분석불동수술절제정도대예후적영향。방법：회고분석2000년1월지2011년12월중산대학종류방치중심수치적96례4기NB환자림상자료。근거원발조수술절제정도장환자분위：A조：미수술혹부활검혹수술절제<50%적원발종류；B조：수술절제50%～90%적원발종류；C조：수술절제>90%적원발종류；D조：수술육안완전절제원발종류。결과：96례4기NB환자，3년PFS화OS분별위32.8%화36.7%。A조24례，B조10례，C조23례，D조39례。A조화B조간PFS비교차이무통계학의의（P=0.352），C조화D조간PFS비교차이무통계학의의（P=0.792）。단C조+D조생존솔고우A조+B조，3년PFS분별위42.2%화17.8%（P <0.001）。결론：4기NB원발종류90%이상완전절제연합화료화（혹）방료가제고생존솔，소량육안잔류혹경하잔류병불영향생존솔。
Objective: To investigate the effect of gross total resection on the local control and survival of patients with stage IV neuroblastoma (NB) and analyze the extent of surgical resection of primary tumors that affects patient survival. Methods: A total of 96 patients with stage Ⅳ NB who were admitted to the Sun Yat-Sen University Cancer Center between January 2000 and December 2011 were analyzed. The patients were treated with combined-modality therapy, including chemotherapy, surgery, and/or radiotherapy. The patients were divided according to the extent of surgical resection of primary tumor into the following groups: group A, biopsy or tumor removal of less than 50% of the primary lesion; group B, incomplete resection of more than 50% but less than 90% of the lesion; group C, removal of more than 90% of the lesion; and group D, complete resection with or without macroscopic residual tumors. The survival rates of each group were analyzed. Results: The median age of the 96 patients was 4.4 years, ranging from 1.2-18.8 years. The overall 3-year progression-free survival (PFS) and overall survival (OS) of the total patients were 32.8% and 36.7%, respectively. A total of 24 cases were assigned in group A, 10 in group B, 23 in group C, and 39 in group D. Subgroup analysis revealed that the 3-year PFS rate was 17.5% for group A, 20.0% for group B, 45.1% for group C, and 40.5% for group D. The PFS rates were not statistically significant-ly different between groups A and B (P=0.352) and between groups C and D (P = 0.792). However, the OS was higher in groups C and D than that in groups A and B. The 3-year PFS rates were 42.2% and 17.8% for groups C and D (P<0.001), respectively. Conclu-sion: Resection extension of more than 90% of the primary tumor combined with chemotherapy and (or) radiation therapy can improve the survival of patients with stage Ⅳ NB. However, this treatment modality does not affect the treatment outcomes for minimal gross tu-mor residuals.
