Park Eun Sil, Kang Hyoung Jin, Shin Hee Young, Ahn Hyo Seop
Department of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea.
J Korean Med Sci. 2006 Jun;21(3):436-40. doi: 10.3346/jkms.2006.21.3.436.
The survival in cases with relapsed Wilms tumor is dismal. Recently, however the introduction of new therapeutic agents and experimental strategies has improved the survival. We analysed the survival of patients with relapsed Wilms tumor according to the treatment period. During the early period 1983-1993, patients who had received two drugs were treated with doxorubicin and the others were treated with cisplatin and etoposide, whereas during the late period 1994-2004, patients were treated with combinations of cyclophosphamide/etoposide and carboplatin/etoposide. During the early period, 8 of 57 experienced relapse, and 8 of 41 relapsed during the late period. Only 2 patients treated during the early period survived in complete response (CR), whereas during the late period, 5 patients remained alive in CR, and 3 of those received high-dose chemotherapy (HDC) with autologous peripheral stem cell rescue (SCR). The estimated 5 yr event-free survival rate was 37.5% in the entire study group, 50% for patients in the late period, and 25% for patients in the early period (p=0.38). The survival in patients with relapsed Wilms tumor dramatically improved during the late period and HDC with SCR was one of the effective salvage strategies.
复发性肾母细胞瘤患者的生存率很低。然而，近年来新治疗药物和实验性策略的引入提高了生存率。我们根据治疗时期分析了复发性肾母细胞瘤患者的生存率。在1983 - 1993年早期，接受两种药物治疗的患者使用阿霉素，其他患者使用顺铂和依托泊苷；而在1994 - 2004年晚期，患者接受环磷酰胺/依托泊苷和卡铂/依托泊苷联合治疗。早期57例中有8例复发，晚期41例中有8例复发。早期治疗的患者中只有2例完全缓解（CR）存活，而晚期有5例CR存活，其中3例接受了高剂量化疗（HDC）及自体外周干细胞救援（SCR）。整个研究组的估计5年无事件生存率为37.5%，晚期患者为50%，早期患者为25%（p = 0.38）。复发性肾母细胞瘤患者的生存率在晚期显著提高，HDC联合SCR是有效的挽救策略之一。
