[1]常晓峰,王焕民,王佳荣,等.细胞减灭术联合腹腔热灌注化疗在局部反复复发肾母细胞瘤治疗中的应用[J].临床小儿外科杂志,2024,(05):464-468.[doi:10.3760/cma.j.cn101785-202203047-012]
　Chang Xiaofeng,Wang Huanmin,Wang Jiarong,et al.Application of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for locally recurrent Wilms tumor[J].Journal of Clinical Pediatric Surgery,2024,(05):464-468.[doi:10.3760/cma.j.cn101785-202203047-012]
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细胞减灭术联合腹腔热灌注化疗在局部反复复发肾母细胞瘤治疗中的应用

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 期数: 2024年05 页码: 464-468 栏目: 论著 出版日期: 2024-05-01
Title:
Application of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for locally recurrent Wilms tumor
作者:
常晓峰1;  王焕民1;  王佳荣2;  孟德光2;  秦红1;  杨维1;  成海燕1;  朱志云1
1 国家儿童医学中心 首都医科大学附属北京儿童医院肿瘤外科, 北京 100045;
2 北京儿童医院保定医院肿瘤外科, 保定 071000
Author(s):
Chang Xiaofeng1;  Wang Huanmin1;  Wang Jiarong2;  Meng Deguang2;  Qin Hong1;  Yang Wei1;  Cheng Haiyan1;  Zhu Zhiyun1
1 Department of Surgical Oncology, Beijing Children’s Hospital Affiliated to Capital Medical University, Beijing 100045, China;
2 Department of Oncology, Baoding Hospital, Beijing Children’s Hospital, Baoding 071000, China
关键词:
细胞减灭术; 腹腔热灌注化疗; 肾母细胞瘤; 外科手术; 儿童
Keywords:
Cytoreductive Surgery; Hyperthermic Intraperitoneal Chemotherapy; Wilms Tumor; Surgical Procedures;  Operative; Child
DOI:
10.3760/cma.j.cn101785-202203047-012
摘要:
目的 观察细胞减灭术(cytoreductive surgery,CRS)联合腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)对反复复发肾母细胞瘤的腹腔局部控制情况。 方法 本研究为回顾性研究,以2019年1月至2022年1月首都医科大学附属北京儿童医院肿瘤外科及北京儿童医院保定医院肿瘤外科收治的6例反复复发的肾母细胞瘤患儿为研究对象,收集患儿基本信息(性别、年龄、发病部位等)、既往治疗经过、治疗方案以及本中心(北京与保定两个病区)手术、热灌注、术后治疗及随访情况。 结果 6例反复复发的肾母细胞瘤患儿均为单侧病变,5例行根治性瘤肾切除术,1例行保留肾脏肿瘤剥除术。4例直接接受手术,参考COG分期,其中2例为Ⅲ期,行化疗+放疗;2例为Ⅱ期,予以化疗;另2例术前予以化疗,参考SIOP分期,术后诊断为Ⅱ期,术后仅行化疗。初次复发时间最短为术后1.5个月,最长为术后10个月,其中3例为原位复发,2例为腹盆腔单发种植病灶,1例为肠系膜多发病变。在治疗过程中,6例复发部位均位于腹盆腔,未见远处转移,且均接受了手术切除;5例进行了局部放疗;6例术后均采用了强于初次化疗的个体化治疗方案。6例在本中心治疗过程中均接受了细胞减灭术+术中腹腔热灌注化疗,术中、术后均未见危及生命的严重并发症;随访时间为14(2,32)个月,其中4例长期生存,2例死于肿瘤进展。 结论 局部反复复发的肾母细胞瘤预后差,在化疗的辅助下,CRS+HIPEC可以最大程度杀灭可能残存的肿瘤细胞,更有利于肿瘤局部控制。
Abstract:
Objective To evaluate the efficacy of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) for locally recurrent nephroblastoma.Methods For this retrospective study,six children with locally recurrent nephroblastoma were recruited from January 2019 to January 2022.Personal demographics (gender,age & disease site),previous protocols,treatment plans,surgical procedures,HIPEC,postoperative management and follow-ups were collected.Results All of them had unilateral lesions.Radical nephrectomy (n=5) and nephron sparing surgery (NSS,n=1) were performed.Two cases of Children’s Oncology Group (COG) stage Ⅲ received chemoradiotherapy while another two of stage Ⅱ had chemotherapy alone.The remainders received preoperative chemotherapy and postoperative International Society of Pediatric Oncology (SIOP) stage was both stage Ⅱ.The shortest time to recurrence was 1.5 months while the longest one 10 months.All abdominopelvic lesions were removed without distant metastases.Five cases received local radiotherapy and intensive postoperative chemotherapy.CRS plus HIPEC were offered without any perioperative life-threatening complication.The median follow-up period was 14(2-32) months).The outcomes were long-term survival (n=4) and tumor progression (n=2).Conclusions The prognosis for locally recurrent nephroblastoma remains unsatifactory.However,with an aid of adjunctive chemotherapy,CRS plus HIPEC are capable of maximizing the eradication of residual tumor cells and thus facilitating local tumor control.

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备注/Memo

收稿日期:2022-03-14。
通讯作者:王焕民,Email:wanghuanmin@bch.com.cn

更新日期/Last Update: 1900-01-01