儿童横纹肌肉瘤"上海儿童医学中心Rs-99方案"临床报告

目的　改善儿童横纹肌肉瘤、生殖细胞性肿瘤、Ewing’s肉瘤等恶性实体瘤预后。 方法　对 1998年10月至 2 0 0 1年 10月明确诊断的横纹肌肉瘤及其它软组织肉瘤、生殖细胞性肿瘤、Ewing’s肉瘤患儿共 17例 ,采用上海儿童医学中心Rs 99方案 ,即外科手术、内科化疗、选择性放疗、病理科与影像学科协作诊断、综合治疗。按方案中条件根据危险因素进行分组 ,并按分组给予分级治疗。结果　 17例恶性实体瘤患儿中 4例自行终止治疗并失访 ,12例获完全缓解 ,1例部分缓解 6个月后进展死亡。随访至 2 0 0 2年 9月 ,12例获缓解者中 1例 2 2个月时复发后死亡 ;1例 2 4个月时复发带病生存至今 35个月。另 10例持续缓解 15～ 4 6个月 ,平均为 2 8个月 ,其中 9例已停药平均 17个月。结论　Rs 99方案诊断及治疗对横纹肌肉瘤、生殖细胞性肿瘤、Ewing’s肉瘤有效。

Results of protocol SCMC Rs-99 for childhood rhabdomyosarcoma

Objective To improve the results of childhood rhabdomyosarcoma,germ cell tumor,Ewing's sarcoma and other solid tumor.Methods Diagnosis and treatment were performed by the multi disciplinary term which included oncologist,surgeon,pathologist,radiologist and diagnostic radiologist.Protocol Rs 99,designed by our term,was used.Patients were grouped by risk factors and treated with different intensity depending on grouping.Results Seventeen patients were enrolled,four of them stopped their treatment by their parents and lost follow up.Twelve reached complete response and one achieved partial response for 6 months and then progressed to death.Two in 12 relapsed and one of them died,one live with disease for 34 months till now.The other ten patients were still in CR for an average 28 months.Nine of them already stopped the treatment depending on the protocol.Conclusion Multi disciplinary term work is an effective model for childhood cancer.The protocol Rs 99 achieves good results in this study.