化疗治疗儿童骨嗜酸性肉芽肿的临床疗效观察

Clinical Analysis of Chemotherapy For Eosinophilic Granuloma of Bone in Children

目的探讨采用化疗治疗儿童骨嗜酸性肉芽肿(EGB)的疗效,提高该病的诊治水平,改善预后。方法回顾性分析我院4年来22例经病理证实的儿童骨嗜酸性肉芽肿病例,其中10例采用了DAL-HX83/90化疗方案,对其疗效进行分析。结果单发8例(36.4%),多发14例(63.6%),发病的部位不同,骨损害的影像学表现不一样。10例患儿接受了诱导和维持两个阶段的化疗,其中7例系单纯手术或局部治疗后复发或多发。6例治愈、3例病灶缩小或稳定,1例多发患者治疗不敏感,有播散和复发。结论单纯手术治疗无法解决EGB的“此起彼伏”现象,采用DAL-HX83/90方案化疗预防其远处播散或后期复发,目的是控制甚至治愈本病,可明显改善预后。

Objective Through studying the clinical curative effect of eosinophilic granuloma of bone(EGB) after chemotherapy in order to improve its diagnosis level and prognosis. Methods Analyzed retrospectively the clinical features,radiological finding and pathophysiology of 22 cases with eosinophilic granuloma of bone proved by surgery or histopathology within the hospital in recent 4 years,after average follow-up period of 34 months. Results Monofocal lesion was found in 8 cases (36.4%) and multifocal lesions were in 14 cases (63.6%). The disease showed serious bone destruction and few clinical signs and symptoms. According to different lesions location,their radiographic characteristics of bone destruction were different. 10 patients received chemotherapy using combination of induction therapy and maintenance therapy. 6 patients were cured. Focuses of 3 patients were reduced or inactivity. Only one patient was low response to therapy occurred,EGB dissemination and relapses. Conclusion Simple operation can not resolve the phenomena of “as one falls,another rises” of the ECG.The standard chemotherapy (DAL-HX 83/90) could prevent advanced relapses and improve prognosis. The goal of treatment is control the disease and prevent permanent organ damage, radicate the disease completely.