摘要
目的分析应用长春新碱、阿表霉素联合环磷酰胺(CAO方案)化疗联合高频聚焦超声消融治疗Ⅲ/Ⅳ期肝母细胞瘤(HB)患儿的疗效。方法回顾性分析2010年12月~2016年1月我科收治的34例Ⅲ/Ⅳ期HB患儿的临床资料,其中16例接受CAO方案化疗联合高频聚焦超声消融治疗,18例仅接受CAO方案化疗治疗。比较两组各项血和生化指标、肿瘤缓解率、化疗不良反应发生率和转归情况。结果在治疗3m末,联合组血清AFP水平为(43.2±5.4)μg/L,ALT水平为(93.5±26.3)U/L,AST水平为(91.2±30.2)U/L,显著低于对照组【分别为(55.3±6.2)μg/L、(197.1±57.8)U/L和(213.7±66.2)U/L,P<0.05】,而两组外周血Hb水平比较,差异无统计学意义(P>0.05);联合组肿瘤缓解率为81.3%,显著高于对照组的61.1%,差异具有统计学意义(P<0.05);联合组化疗不良反应发生率为18.8%,与对照组的27.8%比,差异无统计学意义(P>0.05);在随访24m末,联合组病死率为6.3%,与对照组的11.1%比,差异无统计学意义(P>0.05),但联合组肿瘤复发率为13.3%,显著低于对照组的25.0%,差异具有统计学意义(P<0.05)。结论采取CAO方案化疗与高频聚焦超声消融联合治疗Ⅲ/Ⅳ期HB患儿能有效延缓病情发展,提高肿瘤缓解率,降低复发率。
Objective To investigate the efficacy of combination of vincristine,apixamycin and cyclophosphamide(CAO chemotherapy regimen)combined with high frequency focused ultrasound ablation in the treatment of children with hepatoblastoma(HB)at stageⅢ/Ⅳ.Methods The clinical data of 34 children with HB at stageⅢandⅣrecruited in our hospital between December 2010 and January 2016 were analyzed retrospectively.Out of them,16 patients t were treated with combination of CAO chemotherapy regimen and high-frequency focused ultrasound ablation,and 18 patients were treated with CAO chemotherapy regimen alone.All the children were followed-up for 24 months.The biochemical indicators,tumor relief,adverse reactions of chemotherapy and the outcomes of patients were compared between the two groups.Results At the end of three-month treatment,serum AFP level in the combination group was(43.2±5.4)μg/L,serum ALT level was(93.5±26.3)U/L,and serum AST level was(91.2±30.2)U/L,significantly lower than(55.3±6.2)μg/L,(197.1±57.8)U/L and(213.7±66.2)U/L in the control(P<0.05),while blood Hb levels in the two groups were not significantly different(P>0.05);the tumor remission rate in the combination group was 81.3%,significantly higher than 61.1%in the control(P<0.05);the incidence of side effect in the combination was 18.8%,not significantly different compared to 27.8%in the control(P>0.05);at the end of 24 month followed-up,the fatality rate in the combination group was 6.3%,not significantly different compared to 11.1%in the control(P>0.05),however,the recurrence rate of intrahepatic tumor was 13.3%in combination group,significantly lower than 25.0%in the control(P<0.05).Conclusion The CAO chemotherapy regimen combined with high-frequency focused ultrasound ablation in the treatment of children with stageⅢandⅣHB might be efficient,which delay the tumor growth and reduce the recurrence rate after treatment.
作者
黄仕颖
梁爽
魏杨辉
傅绢
邓凤平
金仙梅
Huang Shiying;Liang Shuang;Wei Yanghui(Department of Ultrasound,Eighth Hospital,Affiliated to Zhongshan University,Shenzhen 518000,Guangdong Province,Chian)
出处
《实用肝脏病杂志》
CAS
2019年第4期569-572,共4页
Journal of Practical Hepatology
关键词
肝母细胞瘤
化疗
高频聚焦超声消融
应答
生存
Hepatoblastoma
Chemotherapy
High-frequency focused ultrasound ablation
Response
Survival
