儿童鼻咽癌临床治疗研究

Treatment of nasopharyngeal carcinoma in children

摘要:

目的：探讨ARAR0331方案对儿童鼻咽癌的治疗效果。方法：回顾性分析2004年5月至2012年5月收治的8例鼻咽癌患儿的临床资料。8例患儿中，男6例，女2例，发病年龄3~13岁；ⅡA期、ⅣA期各1例，Ⅲ期6例。1例（Ⅲ期）采用以EAP、BEP和EA为主的化疗联合放疗的方案，7例采用美国儿童肿瘤协作组（COG）ARAR0331治疗方案。结果：采用以EAP、BEP和EA为主的化疗联合放疗治疗的这例患儿，化疗过程中出现多发骨转移。ARAR0331方案治疗的7例患儿中，4例处于完全缓解，2例处于部分缓解。目前7例患儿均存活，生存率为100%，生存期为8~75个月。ARAR0331治疗并发症主要包括放射性皮炎、口咽黏膜炎及胃肠道反应，未发现远期并发症。结论：ARAR0331方案为有效、安全的治疗儿童鼻咽癌的方法，但需积累更多病例进一步证实。

Abstract:

OBJECTIVE: To evaluate the clinical efficacy of the ARAR0331 protocol for treatment of childhood nasopharyngeal carcinoma. METHODS: The clinical data of eight children with nasopharyngeal carcinoma between May 2004 and May 2012 were retrospectively studied. The eight patients included six boys and two girls, and the onset age was between 3 and 13 years. Six patients were in AJCC Stage Ⅲ, one was in StageⅡA and one was in Stage ⅣA. One patient had been treated with combined radiotherapy and chemotherapy which mainly included EAP, BEP and EA. The other seven patients had been treated with the ARAR0331 protocol provided by the America Children′s Oncology Group (COG). RESULTS: The patient who had been treated with combined radiotherapy and chemotherapy developed multiple bony metastasis during the chemotherapeutic period. Four out of seven patients who had been treated with ARAR0331 protocol achieved complete remission, and two achieved partial remission. The seven patients were followed-up from 8 to 75 months and the survival rate was 100%. The ARAR0331 protocol treatment-related complications included radiodermatitis, mucocitis and nausea. Late toxicity was not found. CONCLUSIONS: Based on the limited cases, ARAR0331 protocol appears to be effective and safe for childhood nasopharyngeal carcinoma.