肾母细胞瘤：开罗大学艾因夏姆斯放射肿瘤学与核医学中心（NEMROCK）儿科病房的经验

Abd El-Aal Hisham H, Habib Emmad E, Mishrif Mohamed M

The Department of Clinical Oncology, Pediatric Oncology Unit, Faculty of Medicine Cairo University.

J Egypt Natl Canc Inst. 2005 Dec;17(4):308-14.

AIM OF THE WORK

The aim of the present work is to study the treatment results of Wilms' tumor patients who had attended the pediatric unit of Kasr El-Aini center of radiation oncology and nuclear Medicine (NEMROCK) from January 1994 to January 2001.

PATIENTS AND METHODS

Sixty-two new Wilms' tumor patients attended the clinic (NEMROCK) from January 1994 until January 2001. The diagnosis was confirmed pathologically. Stage I included 22 cases, stage II 17 cases, stage III 16 cases, and stage IV included 4 cases, whereas stage V included only 3 cases. Stage I cases received 6 months of vincristine and dactinomycin. Stage II with favorable histology (FH) received 1 year of vincristine and dactinomycin. Stage III and IV received 1 year of vincristine, dactinomycin and doxorubicin. Abdominal radiation therapy, 1080cGY, was given in case of tumor spillage during surgery either to the involved flank or the whole abdomen depending on whether contamination was limited to the flank only or the whole abdomen. In addition, radiation was given to metastatic sites in stage IV. Stages II, III, IV with unfavorable histology (UH) received 1 year of dactinomycin, vincristine, doxorubicin and cyclophosphamide in addition to radiation therapy. Stage V cases were diagnosed by surgical biopsy and were managed according to stage and pathology.

RESULTS

Forty patients (64.5%) had favorable histology while twenty-two patients (35.5%) had unfavorable histology. The 4-year overall survival rate was 70.1%. Stage I, II, and stages III+IV+V with favorable histology had a 4-year overall survival of 82.3%, 56% and 41%, respectively. Stages I to IV with unfavorable histology had a 4- year survival of 65.7%.

CONCLUSION

Multivariate analysis revealed that stage and residual disease after surgery significantly affected overall survival; while histopathology and stage affected significantly disease-free survival. Moreover, our study revealed that residual disease after surgery affected significantly the incidence of local recurrence and distant metastases.

工作目的

本研究旨在探讨1994年1月至2001年1月期间在开罗大学艾因·卡斯尔放射肿瘤学与核医学中心（NEMROCK）儿科接受治疗的肾母细胞瘤患者的治疗结果。

患者与方法

1994年1月至2001年1月期间，62例新发肾母细胞瘤患者到该诊所（NEMROCK）就诊。诊断经病理证实。I期22例，II期17例，III期16例，IV期4例，V期仅3例。I期患者接受6个月的长春新碱和放线菌素治疗。组织学类型良好（FH）的II期患者接受1年的长春新碱和放线菌素治疗。III期和IV期患者接受1年的长春新碱、放线菌素和阿霉素治疗。若手术中出现肿瘤破裂，根据污染范围局限于一侧还是累及全腹，对受累侧腹或全腹给予1080cGY的腹部放射治疗。此外，IV期患者的转移部位也接受放射治疗。组织学类型不良（UH）的II、III、IV期患者除接受放射治疗外，还接受1年的放线菌素、长春新碱、阿霉素和环磷酰胺治疗。V期患者通过手术活检确诊，并根据分期和病理情况进行处理。