儿童Ⅳ期颅外恶性生殖细胞肿瘤疗效观察

Study on the clinical outcomes of children with stage Ⅳ malignant extracranial germ cell tumors

目的评估儿童Ⅳ期颅外恶性生殖细胞肿瘤(MGCT)化疗方案的疗效。方法回顾分析2003年6月至2013年12月接受Ⅳ期方案治疗和随访的患儿资料并进行统计学分析。结果 25例Ⅳ期颅外MGCT患儿中,男13例、女12例,中位年龄2.0岁(1~11岁)。剔除外院曾化疗的1例,诊断后放弃治疗的1例,治疗≤2个疗程病情好转中放弃治疗的3例,共20例患儿纳入分析。其中经治疗获得完全缓解(CR)18例(90.0%),部分缓解(PR)1例(5.0%),初治总有效率(CR+PR)为95.0%。中位随访时间55个月(5~156个月),5年无事件生存率(EFS)及总生存率(OS)分别为(70.0±10.2)%及(82.4±9.2)%。治疗过程中没有因合并症导致的死亡。结论此诊疗方案对儿童颅外Ⅳ期MGCT疗效肯定。与PEB(顺铂、依托泊苷、博来霉素)等其他化疗方案相比,药物累积剂量不大,但涉及药物较多,可能导致远期不良反应增多。

Twenty-five patients were enrolled in the retrospective analysis.Event-free survival(EFS)and overall survival(OS)rates were estimated by Kaplan-Meier method with SPSS13.0.Results Of the25children,there were13males and12females.The mean age at diagnosis was2years old(ranged1to11).Five patients receiving chemotherapy in another hospital before(n=1),or giving up treatment after confirmed diagnosis(n=1),or giving up effective treatment after received less than2cycles(n=3)were excluded from this analysis.Of the20patients,90.0%(18/20)achieved complete remission and5.0%(1/20)achieved partialremission after treatment.The5-year EFS rate and5-year OS rate were70.0%±10.2%and82.4%±9.2%respectively.There wasno death occurred due to complications.Conclusions The effect of this treatment program is positive.The cumulative dose ofthe drugs is not high,compared with other schemes such as PEB,but there are more drugs involved.Whether these drugs maycause long-term adverse reactions needs further research