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[1962年至1990年间在一个中心治疗的155例横纹肌肉瘤患儿的治疗进展]

[Progress in the treatment of 155 children with rhabdomyosarcoma obtained in one center between 1962-1990].

作者信息

Perek D, Jurczyk-Procyk S, Zelazowski J, Dembowska-Bagińska B, Kozera M, Witkowska-Ozogowska J, Karwański M

机构信息

Klinika Onkologii Dzieci i Młodziezy Instytutu Matki i Dziecka w Warszawie.

出版信息

Pediatr Pol. 1996 Aug;71(8):667-72.

PMID:8927469
Abstract

The results of treating 155 children with rhabdomyosarcoma using protocols that (RMS) changing over the years between 1962-1990 in reported to progress in chemotherapy (CHT), introduction of megavoltage radiotherapy (RTX) and conservative surgery with attempts to preserve vital organs are presented. In the first period between 1962-1980 when mainly surgery was applied with orthovoltage RTX and low intensity CHT, only 20 of 74 children (27%) survived. In the second period 1981-1985 systemic CHT containing new cytostatic, megavoltage RTX and limited surgery applied in advanced cases after induction of CHT were introduced. Nineteen of 46 children (41.3%) survived. In the last period a 1986-1990 more intensive CHT with an own modified protocol VACA/VAIA and intensification phases containing cisplatinum, etoposide and/or carboplatinum were introduced. Twenty seven of 35 patients (60%) survived. Comparative analysis of the last two periods pointed to significant progress in treatment in III clinical group (IRS classification), (20.7% vs 62.9%) and parameningeal RMS (0% vs 58%). Meaningful improvement concerned also young children below 5 years of age (42.8% vs 73.9%). The main prognostic factors and treatment failures of the recent years were analyzed.

摘要

本文介绍了1962年至1990年间,采用不断变化的治疗方案对155例横纹肌肉瘤(RMS)患儿进行治疗的结果,这些方案在化疗(CHT)方面取得了进展,引入了兆伏放疗(RTX)以及采用了旨在保留重要器官的保守手术。在1962年至1980年的第一阶段,主要采用手术联合常压RTX和低强度CHT,74例患儿中仅有20例(27%)存活。在1981年至1985年的第二阶段,引入了含有新细胞抑制剂的全身CHT、兆伏RTX以及在CHT诱导后应用于晚期病例的有限手术。46例患儿中有19例(41.3%)存活。在最后一个阶段,即1986年至1990年,引入了采用自身改良方案VACA/VAIA的更强化的CHT以及包含顺铂、依托泊苷和/或卡铂的强化阶段。35例患者中有27例(60%)存活。对最后两个阶段的比较分析表明,在III期临床组(IRS分类)(20.7%对62.9%)和脑膜旁RMS(0%对58%)的治疗方面取得了显著进展。有意义的改善也涉及5岁以下的幼儿(42.8%对73.9%)。分析了近年来的主要预后因素和治疗失败情况。

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