儿童横纹肌肉瘤综合治疗疗效观察

摘要

Objective To study diagnosis and treatment of rhabdomyosarcoma (RMS) in children.Method The clinical data of 43 children with RMS was retrospectively reviewed from Nov 2004 to May 2012.Their long-term survival was followed up.Forty-three children with RMS(male 26,female 17) in Beijing Tongren Hospital were enrolled.Their median age on diagnosis was 6 years old.We confirmed the diagnosis according to pathological diagnosis.Comprehensive treatment included chemotherapy,surgery and implantation of radioactive seeds,and so on.Statistical analysis was used on clinical data and treatment efficacy.Result The median follow up time of 43 cases with RMS in children was 31 mouths until May 2012.Four cases abandoned,39 cases were followed up.The cases of complete remission were 27(69％),and the cases of partly remission were 7 (18％),and the cases of dead were 5 due to cerebral metastasis.Overall survival rate was 87％ (34/39).Eight cases were treated with 125I particles implants into its location,7 cases responded,1 case was invalid.Conclusion Although anatomic structure of RMS of head and neck was very complex,and the prognosis of it with metastatic disease was inferior,the muttidisciplinary treatment can still improve the clinical remission rate.In particular,high risk RMS with 125I particles implants and large dose chemotherapy would be beneficial.%目的 研究儿童头颈部横纹肌肉瘤(rhabdomyosarcoma,RMS)诊疗及预后.方法 回顾性分析首都医科大学附属北京同仁医院儿科病房2004年11月至2012年5月收治的43例(男26例,女17例,中位年龄6.0岁)原发于头颈部的RMS.43例患儿均经病理组织学确诊.综合治疗采用规律化疗、手术治疗及放射性粒子植入术等综合治疗.统计分析其临床资料及诊疗疗效.结果 43例头颈RMS随访至2012年5月,中位随访时间31个月(3 ～83个月),放弃治疗4例,获随访39例.39例患儿完全缓解27例(69％),带瘤存活达部分缓解7例(18％),5例因脑转移死亡.总生存率达到87％(34/39).8例头颈部患儿行125Ⅰ放射性粒子组织间植入,有效7例,无效1例.结论 对于儿童头颈部RMS应提倡多学科综合治疗.125Ⅰ粒子组织间植入、常规化疗、大剂量化疗等多种综合治疗方法对于提高肿瘤缓解率具有一定的临床意义.