Saliyeva Symbat, Boranbayeva Riza, Bulegenova Minira, Zhumadullayev Bakhram, Nurzhanova Gaukhar, Manzhuova Lyazat
Oncology/hematology Department, Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan.
Department of Children's Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
Rare Tumors. 2024 Apr 1;16:20363613231216567. doi: 10.1177/20363613231216567. eCollection 2024.
The purpose of this study was to analyze the outcomes of extracranial GCT in children in a developing country and to assess prognostic factors. The data on 141 children (<18 years old) with extracranial GCT, confirmed histopathologically, collected over the past 9 years (from February 2013 to June 2022) were retrospectively studied. The patients underwent the same therapy with platinum-containing chemotherapy regimens. In the malignant GCT group, OS and EFS were 81.0 ± 4% and 73 ± 5%, respectively. OS and EFS in the teratoma group were 90 ± 5% and 85 ± 6%. In univariate analysis, parameters like stage of disease, tumor localization, AFP level ≥10,000 ng/mL, serum AFP kinetics and resection status were found to be statistically significant prognostic factors. In the multivariate analysis, the significant adverse factors were the resection status, initial AFP level ≥10,000 ng/mL and serum AFP kinetics slow down ( = .000). Good survival rates can be achieved in developing countries with adequate compliance with treatment protocols. The analysis demonstrates high efficacy of platinum-containing chemotherapy regimens. In our opinion, the protocol used in high-income countries can be implemented in low-income countries with the financial support from the government. The qualification of specialists is also important.
本研究的目的是分析发展中国家儿童颅外生殖细胞肿瘤（GCT）的治疗结果，并评估预后因素。回顾性研究了过去9年（2013年2月至2022年6月）收集的141例经组织病理学确诊的颅外GCT儿童（<18岁）的数据。患者接受了含铂化疗方案的相同治疗。在恶性GCT组中，总生存期（OS）和无事件生存期（EFS）分别为81.0±4%和73±5%。畸胎瘤组的OS和EFS分别为90±5%和85±6%。单因素分析发现，疾病分期、肿瘤定位、甲胎蛋白（AFP）水平≥10,000 ng/mL、血清AFP动力学和切除状态等参数是具有统计学意义的预后因素。多因素分析显示，显著的不良因素为切除状态、初始AFP水平≥10,000 ng/mL和血清AFP动力学减慢（P = .000）。在发展中国家，只要充分遵守治疗方案，就能取得良好的生存率。分析表明含铂化疗方案具有很高的疗效。我们认为，在政府的财政支持下，高收入国家使用的方案可以在低收入国家实施。专家的资质也很重要。
