20例儿童横纹肌肉瘤临床特点与治疗策略分析

Clinical analysis of clinical features and treatment strategies of 20 cases of children rhabdomyosarcoma

目的对20例儿童横纹肌肉瘤临床特点与治疗策略进行分析。方法回顾分析我院2008年2月～2010年2月收治的20例儿童横纹肌肉瘤的临床资料,均由病理组织学确诊为儿童横纹肌肉瘤,对所有病例的病理类型、症状特点和治疗方法进行研究。结果 20例儿童横纹肌肉瘤中,发病年龄2～13岁,平均7.5岁;临床分期中Ⅰ期2例,Ⅱ期8例,Ⅲ期5例,Ⅳ期5例;其中胚胎型11例、腺泡型7例、多形型2例。原发灶部位在躯干者3例、四肢者8例,头颈部者4例,泌尿生殖系统者5例。首发表现因原发部位差异而有所不同,所有患者采用两种以上方式综合治疗,治疗后的疗效评价为:CR 9例,PR 5例,SD 4例,PD 2例。对所有患者连续随访2～4年,1年生存率为90.0%,2年生存率为75.0%,3年生存率为65.0%。结论儿童横纹肌肉瘤是极度恶性软组织肿瘤,要做到早诊断,科学地选择手术与放化疗结合的综合治疗方式,避免拖延造成肿瘤晚期的多发转移,从而提高患儿肿瘤的治愈可能性。

Objective To analyze the clinical features and treatment strategies of 20 cases of children rhabdomyosarcoma.Methods Clinical data of 20 children with children rhabdomyosarcoma from February 2008 to February 2010 in our hospital were retrospectively analyzed,20 cases of children rhabdomyosarcoma were diagnosed by histopathology.The pathological type,the characteristics of symptoms and treatment study of all patients were studied.Results Among 20 cases of patients with children rhabdomyosarcoma,age from 2-13 years,the average of 7.5 years.Clinical stage： 2 cases were in stage Ⅰ,8 cases were stage Ⅱ,5 cases were in stage Ⅲ,5 cases were stage Ⅳ;embryonal of 11 cases,7 cases of alveolar,pleomorphic type of 2 cases.The primary tumor of 3 cases were sited in the trunk,8 cases in the limbs,and 4 cases in head and neck,5 cases in thegenitourinary system.The first manifestation of the tumor was different because of the different primary sites.All patients were carried two or more ways of comprehensive treatments.After treatment,the evaluation of the efficacy： CR 9 cases,PR 5 cases,SD 4 cases and PD 2 cases.All patients were followed up for 2 years to 4 years.The results suggested 1-year survival rate was 90.0%,and 2-year survival rate was 75.0%,3-year survival rate was 65.0%.Conclusion Children rhabdomyosarcoma is an extremely malignant soft tissue tumor.To achieve early diagnosis,we should choose the scientific comprehensive treatment including surgery and radiotherapy and chemotherapy.Combined treatments can avoid multiple metastases of advanced cancer,thereby increase the probability of cure of children with tumors.