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小儿泌尿生殖系统横纹肌肉瘤

Pediatric urologic rhabdomyosarcoma.

作者信息

Stehr Maximilian

机构信息

Pediatric Surgical Hospital, Ludwig-Maximilians-University Munich, Lindwurmstr, Munich, Germany.

出版信息

Curr Opin Urol. 2009 Jul;19(4):402-6. doi: 10.1097/MOU.0b013e32832c90c2.

Abstract

PURPOSE OF REVIEW

To review on the most significant and recent developments in basic research, diagnostic, and therapeutic aspects of genitourinary rhabdomyosarcomas (RMS) in children.

RECENT FINDINGS

Collaborative studies have dramatically improved therapy of genitourinary RMS with a remarkable improvement of survival. However, refractory or relapsed disease is still the most demanding challenge. Advances in our understanding of RMS molecular biology evolve new risk stratification and new therapeutic targets such as growth factors and their receptors. High-quality imaging is crucial and integrated fluorodeoxyglucose positron emission tomography/computed tomography significantly increased sensitivity. Alternative chemotherapeutical strategies were proven. Mutilating primary surgery should be avoided. Modern irradiation modalities with decrease of local radiation dose and, therefore, less long-term effects are new tools in the therapeutic arsenal of therapists.

SUMMARY

Therapy-associated morbidity after current RMS treatment can be significantly decreased by including modern strategies, especially in the field of irradiation. However, the follow-up is too short so far to make a distinct decision. The advances in understanding tumor biology may give rise to clinically relevant new therapeutic targets in the near future.

摘要

综述目的

回顾儿童泌尿生殖系统横纹肌肉瘤(RMS)基础研究、诊断及治疗方面最重要的最新进展。

最新发现

合作研究显著改善了泌尿生殖系统RMS的治疗,生存率有显著提高。然而,难治性或复发性疾病仍是最严峻的挑战。我们对RMS分子生物学认识的进展催生了新的风险分层以及生长因子及其受体等新的治疗靶点。高质量成像至关重要,氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描相结合显著提高了敏感性。已证实了替代化疗策略。应避免进行致残性的初次手术。降低局部辐射剂量从而减少长期影响的现代放疗方式是治疗师治疗手段中的新工具。

总结

采用现代策略,尤其是在放疗领域,可显著降低当前RMS治疗后与治疗相关的发病率。然而,目前随访时间过短,尚无法做出明确判断。对肿瘤生物学认识的进展可能在不久的将来带来具有临床意义的新治疗靶点。

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