基于儿童肾母细胞瘤-2016诊疗规范的单中心疗效分析(附38例)

目的:应用儿童肾母细胞瘤(Wilms tumor,WT)-2016诊疗规范对单中心WT患儿的临床疗效进行分析.方法:回顾性分析2017年02月至2020年03月,采用CCCG-WT-2016方案治疗肾母细胞瘤患儿的临床资料,分析其临床特点及治疗转归,并采用Kaplan-Meier法分析3年无事件生存(event-fre...

Single-center efficacy analysis based on pediatric Wilms tumor-2016 diagnosis and treatment regimen(38 cases)

Objective:To explore the clinical efficacy of children with Wilms tumor by adopting children WT-2016-protocol in single center.Methods:The clinical data of Wilms tumor treated with CCCG-WT-2016 protocol from February 2017 to March 2020 were retrospectively,their clinical features and therapeutic prognosis were analyzed retrospective.3-year event-free survival(EFS)rate and overall survival(OS)rate of each group were analyzed by Kaplan-Meier curve method.Results:A total of 38 children(27 boys and 11 girls)were included,with a median age of 22.0(5.2~84.0)months.The pathological classification were 33 cases of favorable histology(FH)type including 2 cases of teratoma-like Wilms tumor,and 1 case of unfavorable histology(UFH)type,4 cases clear cell sarcoma of kidney.The children were followed up until March 2021,median follow-up time was 30.5(11.2~48.5)months.There were 2 deaths,of which 1 was due to recurrence,1 was bilateral Wilms tumor which has not remission,and died of tumor progression.There were 3 cases of recurrence,including 2 cases of metastasis to the lungs(1 case of in-situ tumor recurrence with pulmonary metastasis)and 1 case of multiple tumor metastases in the abdominal and pelvic cavity.The 3-year event-free survival(EFS)rate of FH group was(84.6±9.2)%.Among them,EFS rate in stageⅠandⅡwas 100%,EFS rate in stageⅢ,stageⅣand stage V were(85.7±13.2)%,(80.0±17.9)%and(66.7±27.2)%respectively.The Log-Rank test showed that there was no statistical significance in prognosis of children between stageⅠ+Ⅱand stageⅢ+Ⅳ+Ⅴ(χ²=2.691,P=0.101).The 3-year overall survival(OS)rate of FH group was(91.7±8.0)%.Among them,OS rate in stageⅠ,ⅡandⅢwas 100%,OS rate in stageⅣand stage V were(81.1±9.3)%and(70.0±8.5)%respectively.The Log-Rank test showed that there was no statistical significance in prognosis of children between stageⅠ+Ⅱ+Ⅲand stageⅣ+Ⅴ(χ²=2.380,P=0.123).In 4 cases of clear cell sarcoma of kidney,the 3-year EFS rate was(75.0±21.7)%,and the cumulative OS rate was 100%.Conclusion:Treating patients with WT by using CCCG-WT-2016 protocol according to clinical stage can achieve very high 3-year EFS rate and OS rate.