McCormack C J, Naim J O, Rogers D W, Ziegler M M, Hinshaw J R
Department of Surgery, Rochester General Hospital, New York.
J Pediatr Surg. 1989 Feb;24(2):201-3. doi: 10.1016/s0022-3468(89)80249-0.
Treatment of neuroblastoma in children consists of primary excision with adjuvant radiation and chemotherapy. When the tumor invades surrounding structures that cannot be safely excised or when distant metastasis is present, the patient has a poor prognosis. Because the CO2 laser can be used to excise malignant tumors without seeding the surrounding tissue and because the defocused beam can vaporize malignant cells, we compared partial scalpel excision and partial laser excision of C1300 murine neuroblastoma to the growth rate of residual tumor. In 25 mice, 75% of the tumor was excised with a scalpel, and in another 25, the same percentage was excised with the CO2 laser (10 W). CO2 laser excision significantly decreases the growth of residual neuroblastoma (P less than .01). However, the effect appears to be a function of increased tumor immunogenicity after laser excision rather than the increased tumor kill. We conclude that CO2 laser excision of neuroblastoma may prove to be superior to scalpel excision for primary surgical treatment of neuroblastoma.
儿童神经母细胞瘤的治疗包括手术切除原发灶并辅以放疗和化疗。当肿瘤侵犯无法安全切除的周围结构或出现远处转移时，患者预后较差。由于二氧化碳激光可用于切除恶性肿瘤而不播散至周围组织，且散焦光束可汽化恶性细胞，我们比较了C1300小鼠神经母细胞瘤的部分手术刀切除和部分激光切除对残余肿瘤生长速度的影响。在25只小鼠中，用手术刀切除75%的肿瘤，在另外25只小鼠中，用二氧化碳激光（10瓦）切除相同比例的肿瘤。二氧化碳激光切除显著降低了残余神经母细胞瘤的生长（P小于0.01）。然而，这种效果似乎是激光切除后肿瘤免疫原性增加的结果，而非肿瘤杀伤增加。我们得出结论，对于神经母细胞瘤的一期手术治疗，二氧化碳激光切除可能优于手术刀切除。
