多学科综合治疗儿童肾脏恶性肿瘤毒副作用分析

Analysis of toxicity and side effects of multidisciplinary comprehensive treatment of renal malignant tumor in children

目的:对多学科综合治疗在肾脏恶性肿瘤患儿中的毒副作用进行系统探析.方法:将2015年1月~2020年1月我院收治的30例肾脏恶性肿瘤患儿纳入研究中,根据临床病理诊断情况分成预后良好组(23例)和预后不良组(7例);分析两组毒副作用发生情况及与预后的关系.结果:预后不良型患儿总生存率(OS)为85.71%明显低于预后良好型患儿(100%);两组患儿骨髓抑制均以粒细胞减少为主,其发生率无明显差异,所有毒副作用均经对症治疗后缓解,未发生相关性死亡事件;预后不良型胃肠道反应、肝脏毒性发生率明显高于预后良好型;整体并发感染发生率达27.31%(68/249),以呼吸道和血流感染为主;无肾脏损害,神经系统副作用等.结论:多学科综合治疗儿童肾脏恶性肿瘤会出现血液系统、消化系统、循环系统及呼吸系统等多方面的毒副作用,但与毒副作用相关的死亡率少见,整体缓解率高,提示该方案安全有效.

Objective To systematically investigate the toxic effects of multidisciplinary combination therapy in children with renal malignancies.Methods Thirty children with renal malignancies admitted to our hospital from January 2015 to January 2020 were included in the study,and were divided into a good prognosis group(23 cases)and a poor prognosis group(7 cases)according to the clinicopathological diagnosis;the occurrence of toxic side effects and the relationship with prognosis in the two groups were analyzed.Results The overall survival rate(OS)of children with poor prognosis was 85.71%significantly lower than that of children with good prognosis(100%);bone marrow suppression was predominantly granulocytopenia in both groups,the incidence of which did not differ significantly;all toxicities resolved with symptomatic treatment and no associated deaths occurred;the incidence of gastrointestinal reactions and liver toxicity was significantly higher in the poor prognosis group than in the good prognosis group;the overall incidence of concurrent infections The overall incidence of concurrent infections was 27.31%(68/249),mainly respiratory and bloodstream infections;no renal damage,neurological side effects,etc.Conclusion Integrated multidisciplinary treatment of renal malignancies in children is associated with various toxicities in the haematologi-cal,digestive,circulatory and respiratory systems,but mortality associated with toxicities is rare and the overall remission rate is high,suggesting that the programme is safe and effective.