经导管动脉化疗栓塞术治疗41例儿童实体肿瘤的临床研究

Clinical analysis of transcatheter arterial chemoembolization for treating pediatric solid tumors in 41 cases

目的评价经导管动脉化疗栓塞术(TACE)治疗Ⅰ期根治性手术困难的骨肉瘤、肾母细胞瘤、肝母细胞瘤及特大型混合性血管瘤的可行性及疗效。方法回顾性分析2005年8月至2011年8月成都市妇女儿童中心医院收治的Ⅰ期根治性手术切除困难的41例实体肿瘤患儿病历资料,其中,骨肉瘤5例,肾母细胞瘤7例,肝母细胞瘤4例,特大型混合性血管瘤25例。均采用TACE治疗,比较治疗前、后肿瘤大小变化,并随访其临床疗效。结果 5例骨肉瘤、7例肾母细胞瘤、4例肝母细胞瘤术前各经1～3次TACE治疗,体积缩小率分别为24.9%～36.5%(平均25.7%)、18.8%～36.9%(平均25.3%)、43.3%～54.9%(平均50.0%)。随访7～69个月,根治性手术成功率87.5%,2例死亡,14例获得无瘤生存。25例特大型混合性血管瘤分别经1～4次TACE治疗,体积缩小44.3%～100%(平均69.4%),随访3～61个月,治疗有效率96%。结论 TACE是一种安全、有效的治疗手段,可以作为Ⅰ期根治性手术困难的骨肉瘤、肾母细胞瘤、肝母细胞瘤术前治疗方法及特大型混合性血管瘤的首选治疗手段。

Objective To evaluate the efficacy of transcatheter arterial chemoembolization（TACE）in managements of osteosarcoma,wilms′tumor,hepatoblastoma and huge mixed hemangiomas which can hardly be recected radically during stageⅠ.Methods We retrospectively analyzed 41cases of solid tumor which can hardly be recected radically during stageⅠfrom Aug 2005to Aug 2011.All of them underwent TACE,including 5cases of osteosarcoma,7cases of Wilms tumor,4cases of hepatoblastoma,25cases of huge mixed hemangioma.The shrinkage of solid tumors between pre-operation and post-operation was compared.And the clinical effect was observed.Results 5cases of osteosarcoma,7cases of Wilms tumor,4cases of hepatoblastoma underwent once to three times of TACE before resection.The reduction in volume was 24.9%-36.5%,18.8%-36.9%,43.3%-54.9%;and the mean shrinkage was 25.7%,25.3%,50%respectively.The success rate of radical surgery was 87.5%.Their follow-up periods were seven months to sixty-nine months.The result showed the death of two cases and event-free survival of 14cases.Moreover,25cases with huge mixed hemangioma were cured by once to four times of TACE.The reduction of huge mixed hemangioma in volume was 44.3%-100%,and the mean shrinkage was 69.4%.The follow-up periods were three months to sixty-one months.The effective rate reached 96%.Conclusion The technology of TACE is a safe and effective modality.It can be used as a preoperative therapeutic method in osteosarcoma,Wilms tumor and hepatoblastoma which can hardly be recected radically during stageⅠ.Also it is considered as a preferred modality in curing huge mixed hemangiomas.