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多中心多学科治疗对儿童肾恶性肿瘤的临床疗效

[Clinical effect of multicenter multidisciplinary treatment in children with renal malignant tumors].

作者信息

Yin Ze-Xi, He Xiang-Ling, He Jun, Tian Xin, Zhu Cheng-Guang, Chen Ke-Ke, Zou Run-Ying, You Ya-Lan, Jiang Xin-Ping, Tang Wen-Fang, Zeng Min-Hui, Huang Zhi-Jun, Yao An-Qi

机构信息

Department of Hematology and Oncology, First Affiliated Hospital of Hunan Normal University/Children's Medical Center of Hunan Provincial People's Hospital, Changsha 410005, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2021 Feb;23(2):169-173. doi: 10.7499/j.issn.1008-8830.2010023.

Abstract

OBJECTIVE

To study the long-term clinical effect of multicenter multidisciplinary treatment (MDT) in children with renal malignant tumors.

METHODS

A retrospective analysis was performed on the medical data of 55 children with renal malignant tumors who were diagnosed and treated with MDT in 3 hospitals in Hunan Province from January 2015 to January 2020, with GD-WT-2010 and CCCG-WT-2016 for treatment regimens. A Kaplan-Meier survival analysis was used to analyze the survival of the children.

RESULTS

Of the 55 children, 10 had stage I tumor, 14 had stage Ⅱ tumor, 22 had stage Ⅲ tumor, 7 had stage IV tumor, and 2 had stage V tumor. As for pathological type, 47 had FH type and 8 had UFH type. All children underwent complete tumor resection. Of the 55 children, 14 (25%) received preoperative chemotherapy. All children, except 1 child with renal cell carcinoma, received postoperative chemotherapy. Among the 31 children with indication for radiotherapy, 21 (68%) received postoperative radiotherapy. One child died of postoperative metastasis. The incidence rate of FH-type myelosuppression was 94.4%, and the incidence rate of UFH-type myelosuppression was 100%. The median follow-up time was 21 months and the median survival time was 26 months for all children, with an overall survival rate of 98% and an event-free survival rate of 95%.

CONCLUSIONS

Multicenter MDT has the advantages of high success rate of operation and good therapeutic effect of chemotherapy in the treatment of children with renal malignant tumors, with myelosuppression as the most common side effects, and radiotherapy is safe and effective with few adverse events. Therefore, MDT has good feasibility, safety, and economy.

摘要

目的

探讨多中心多学科治疗(MDT)对儿童肾恶性肿瘤的长期临床疗效。

方法

回顾性分析2015年1月至2020年1月在湖南省3家医院接受MDT诊断和治疗的55例儿童肾恶性肿瘤患者的医疗资料,治疗方案采用GD-WT-2010和CCCG-WT-2016。采用Kaplan-Meier生存分析法分析患儿的生存情况。

结果

55例患儿中,Ⅰ期肿瘤10例,Ⅱ期肿瘤14例,Ⅲ期肿瘤22例,Ⅳ期肿瘤7例,Ⅴ期肿瘤2例。病理类型方面,47例为FH型,8例为UFH型。所有患儿均行肿瘤完整切除。55例患儿中,14例(25%)接受术前化疗。除1例肾细胞癌患儿外,所有患儿均接受术后化疗。31例有放疗指征的患儿中,21例(68%)接受术后放疗。1例患儿死于术后转移。FH型骨髓抑制发生率为94.4%,UFH型骨髓抑制发生率为100%。所有患儿中位随访时间为21个月,中位生存时间为26个月,总生存率为98%,无事件生存率为95%。

结论

多中心MDT治疗儿童肾恶性肿瘤具有手术成功率高、化疗疗效好的优点,骨髓抑制为最常见的副作用,放疗安全有效,不良事件少。因此,MDT具有良好的可行性、安全性和经济性。

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