伊立替康姑息性化疗方案在复发或难治性儿童肾母细胞瘤中的应用体会

Experience of irinotecan as palliative chemotherapy in pediatric patients with recurrent or refractory Wilms tumor

目的:本文报道6例复发或难治性肾母细胞瘤(Wilms tumor,WT)高危组及极高危组治疗经验。方法:6例患儿应用伊立替康单药治疗,方案为:(30~50)mg/(m^2·d),持续静点60分钟,d_(1~5),每21天为一个周期。结果:3例得到部分缓解,1例稳定,2例进展。总体耐受性较好,6例患儿共进行21个周期化疗,骨髓抑制发生率为50.0%(3/6),Ⅳ度严重骨髓抑制发生率为16.7%(1/6);腹泻发生率为33.3%(2/6),Ⅲ-Ⅳ度严重腹泻发生率为16.7%(1/6);呕吐发生率为50.0%(3/6),Ⅲ-Ⅳ度严重呕吐发生率为0(0/6);肝功能损伤发生率为33.3%(2/6),Ⅲ-Ⅳ度严重肝功损伤发生率为16.7%(1/6)。未发现毒副反应致死病例,并且6例患儿生活质量得到提高。结论:应用伊立替康化疗方案治疗复发或难治性肾母细胞瘤患儿有一定的疗效,值得进一步研究及探讨。

Objective：To observe the efficacy and side effects of irinotecan for patients with recurrent or refractory Wilms tumor who belonged to high-risk and very-high-risk groups.Methods：Six cases of patients were retrospectively analyzed,（30~50） mg/（m2·d）,continous intravenous drip infusion 60 min,d1~5,every 21 days is a cycle.Results：3 patients were PR,1 patient was SD,2 patients were PD.Atotal of 21 cycles chemotherapy were performed in the 6 patients. Bone marrow suppression occurred in 50.0% patients（3/6）, and Ⅳ toxicities occurred in 16.7%（1/6）.Diarrhea occurred in 33.3% patients（2/6）, and Ⅲ-Ⅳ toxicities occurred in 16.7%（1/6）. Vomiting occurred in 50.0% patients（3/6）, and Ⅲ-Ⅳ toxicities occurred in 0（0/6）. Liver function damage occurred in 33.3% patients （2/6）, and Ⅲ-Ⅳ toxicities occurred in 16.7%（1/6）.No treatment related death occurred during the study, the quality of life of patients had been improved.Conclusion：Irinotecan as palliative chemotherapy for patients with recurrent or refractory Wilms tumor has certain effect,is worthy of further exploration and promotion.