36例儿童横纹肌肉瘤疗效分析

目的:探讨儿童横纹肌肉瘤的临床特点、治疗方法及疗效。方法:分析我院2011年6月至2017年6月收治的36例横纹肌肉瘤患儿的临床资料,总结临床特点,评判疗效及预后。结果:36例患儿中男20例,女16例,中位年龄3.5岁;原发于头颈部16例,躯干13例,泌尿生殖系统4例,四肢3例;其中胚胎型30例,腺泡型5例,多形型1例。IRS临床分期Ⅰ期1例,Ⅱ期11例、Ⅲ期16例、Ⅳ期8例,其中低危1例,中危23例,高危12例。3例接受手术+放疗,15例接受手术+化疗,18例接受以手术、化疗及放疗为主的综合治疗;总病例中CR 17例,PR 6例,SD 5例,PD 8例,CR率47.2%,3年OS率为63.9%。结论:儿童横纹肌肉瘤好发于头颈部及躯干,病理类型以胚胎型为主,手术、化疗联合放疗为主的综合规范治疗方案是提高儿童横纹肌肉瘤疗效的重要途径。

Analysis on treatment efficacy of 36 cases of children rhabdomyosarcoma

Objective:To study the clinical features，the comprehensive treatment，curative effect in children with rhabdomyosarcoma．Methods:Clinical data of 36 children with rhabdomyosarcoma from June 2011 through June 2017 were retrospectively studied.The clinical characteristics，comprehensive treatment efficacy and prognosis of these cases were analyzed.Results:Among the 36 cases，20 were males and 16 were females.The median age was 3.5 years old．16 cases original sites were head and neck，13 cases in trunk，4 cases in the genitourinary system and 3 case in limbs.There were 30 cases of embryonic type，5 cases of alveolar type and 1 case of polymorllhous type.According to The United States Rhabdomyosarcoma Study Group(IRS) staging system，stage Ⅰ had 1 case，stageⅡ 11 cases，stage Ⅲ 16 cases and Ⅳ 8 cases.Among these cases，1 case was in the low risk group，23 case in the median risk group and 12 cases in high risk group.3 cases underwent surgery plus radiotherapy，15 cases underwent surgery plus chemotherapy and 18 patients underwent combined standard treatment(surgery，chemotherapy and radiotherapy)．The efficacy rates:CR 17 cases，PR 6 cases，SD 5 cases，PD 8 cases included.The CR rate was 47.2％ and the OS rate of 3 years was 63.9%.Conclusion:Head，neck and trunk are commoll sites of RMS in children.The embryo type is the most common pathological type.The comprehensive standard treatment method(surgery，chemotherapy，radiotherapy)has an important role in improving the prognosis of children rhabdomyosarcoma．