28例肾母细胞瘤的诊断治疗

Diagnosis and therapy on 28 patients with Wilms' tumor

目的探讨肾母细胞瘤诊治方法 ,旨在提高患儿存活率。方法回顾性分析本院收治的肾母细胞瘤28例,由小儿外科、肿瘤科、病理科、放射诊断及治疗科联合诊断,28例实施手术、化疗及放疗等方法综合治疗;年龄<1岁,Ⅰ期及Ⅱ期预后良好型不放疗。结果 28例分型:预后良好型21例,预后不良型7例;分期:Ⅰ期2例;Ⅱ期11例;Ⅲ期8例;Ⅳ期7例。随访28例,26例获得有效缓解(92.9%);3年生存率为78.6%(22/28)。6例未获得缓解者均死于疾病进展,无治疗相关性死亡。结论多学科联合诊断、综合治疗肾母细胞瘤可以取得良好疗效。手术是根本的治疗方法 ,术后标准放化疗对于肾母细胞瘤的预后至关重要。

Objective To study the diagnoses and treatments of Wilms＇tumor in children for improving its prognosis.Methods Diagnosis and treatment were decided by the multi-disciplinary teams including pediatric surgeons,oncologists,pathologists,radiologists and radiotherapiests.28 cases patients undergone treatment s of Wilms＇ tumors in children were retrospectively reviewed.All of them underwent operation and standardized postoperative chemotherapy.No radiation therapy was used for patients younger than 1 year old,or at stage and favorable-histology（FH）stage Ⅱ.Results Pathologic analysis showed that 21 cases were at FH,7 cases at unfavorable-histology（UFH）.2 patients were at stage Ⅰ,11 patients at stage Ⅱ,8 patients at stage Ⅲ,7 patients at stage Ⅳ.26 patients reached effective response（CR＋PR 92.9 %）.3 years survival（EFS）was 78.6%（22/28）,and 6 cases died of tumor progress.Notherapy-related death happened.Conclusion Multi-disciplinary teams work model and our protocol is very effective for Wilms＇ tumor.Resection is basic method of treatment for these tumors.Standardized postoperative chemotherapy and radiotherapy is vital for the prognosis of Wilms＇ tumor.