儿童横纹肌肉瘤复发及预后的影响因素分析

Influencing factors of relapse and prognosis of rhabdomyosarcoma in children

目的:探讨横纹肌肉瘤(rhabdomyosarcoma,RMS)的复发及预后的影响因素。方法:回顾性分析2000年1月至2017年10月天津医科大学肿瘤医院儿童肿瘤科收治的91例RMS患儿的临床病理资料。采用单因素χ~2检验或Fisher确切概率法和Logistic回归分析影响RMS复发的危险因素,并采用Kaplan-Meier法及Cox风险模型对RMS复发患儿进行预后影响因素分析。结果:RMS复发率为41.8%,复发组38例患儿1、3、5年生存率分别为97.4%、52.9%、27.8%。患儿的临床分期、危险度分组、是否伴有转移及是否规范化疗是影响RMS患儿复发的危险因素,其中是否规范化疗是影响复发的独立危险因素(P<0.05)。生存分析表明复发时间及是否伴有转移与RMS复发患儿的预后相关,且均为独立影响因素(P<0.05)。结论:进行规范化疗有助于降低RMS的复发率,复发时间及是否伴有转移与复发患儿预后相关。

Objective:To investigate the factors affecting the relapse and prognosis of rhabdomyosarcoma(RMS)in children.Methods:The clinical and pathological data of 91 patients with RMS between January 2000 and October 2017 in Tianjin Medical University Cancer Hospital were retrospectively analyzed.The single-factor chi-square test or Fisher's exact probability test and Logistic regression analysis were used to analyze the risk factors affecting RMS relapse.The prognostic factors of patients with recurrent RMS were assessed using Kaplan-Meier analysis and the Cox risk model.Results:The RMS recurrence rate was 41.8%.The 1-,3-,and 5-year survival rates in the recurrent group were 97.4%,52.9%,and 27.8%,respectively.The clinical stage,risk grouping,development of metastasis,and administration of standard chemotherapy were risk factors for RMS recurrence,among which the administration of standard chemotherapy was an independent risk factor for relapse(P<0.05).Survival analysis showed that the time to relapse and development of metastasis were associated with the prognosis of recurrent patients,and these were both independent factors(P<0.05).Conclusions:Standard chemotherapy helps reduce the recurrence rate of RMS.The time to relapse and development of metastasis are associated with the prognosis of recurrent patients.