Wilimas J A, Hammond E, Douglass E C, Champion J, Parvey L, Coburn T
Med Pediatr Oncol. 1984;12(3):221-3. doi: 10.1002/mpo.2950120316.
We performed routine computerized tomography (CT) of the chest and abdomen on patients treated for Wilms' tumor and reviewed the records of all patients who relapsed (10 patients) and 43 additional patients followed for at least 1 year. Routine chest radiographs and abdominal ultrasounds were compared with 210 CT examinations (107 chest and 103 abdomen). CT examinations were obtained at 6 months for stage I (13 patients) and at 3, 8, and 15 months for stages II, III, and IV (40 patients). Of the 10 patients who relapsed, only 2 were documented by CT scan in the absence of clinical symptomatology and presence of normal radiographs and ultrasound. Eight relapses were diagnosed by physical examination, chest radiograph, or ultrasound and confirmed by CT scan. Questionably abnormal CT scans were obtained in 7 patients, only 1 of whom eventually relapsed. Since only 2 of 210 routine CT examinations were the the only indicator of relapse, we conclude that the routine use of CT for follow-up in Wilms' tumor is not warranted.
我们对接受肾母细胞瘤治疗的患者进行了胸部和腹部的常规计算机断层扫描（CT），并回顾了所有复发患者（10例）以及另外43例随访至少1年患者的记录。将常规胸部X线片和腹部超声与210次CT检查（107次胸部和103次腹部）进行比较。I期（13例患者）在6个月时进行CT检查，II、III和IV期（40例患者）在3、8和15个月时进行CT检查。在10例复发患者中，只有2例在无临床症状且X线片和超声检查正常的情况下通过CT扫描记录下来。8例复发通过体格检查、胸部X线片或超声诊断，并经CT扫描证实。7例患者获得了可疑异常的CT扫描结果，其中只有1例最终复发。由于210次常规CT检查中只有2次是复发的唯一指标，我们得出结论，肾母细胞瘤随访中常规使用CT是不必要的。
