WT-2009方案治疗儿童肾母细胞瘤疗效及安全性分析

Efficacy and safety of the WT-2009 chemotherapy protocol in treatment of Wilms' tumor in children

摘要:

目的 探讨WT-2009 方案治疗儿童肾母细胞瘤的疗效及安全性。方法 回顾性分析2009 年7月至2013 年12 月确诊的34 例肾母细胞瘤患儿的临床资料,其中2 例确诊后死亡,6 例放弃治疗,余26 例按照儿童肾母细胞瘤化疗方案(WT-2009)进行治疗。采用Kaplan-Meier 方法分析患儿预期2 年累积总生存率及2年无事件生存率。结果 病理分型以预后良好型(包括上皮细胞型、胚芽型和混合型)为主(88%,30/34);首发症状以腹部包块为主(56%,19/34)。26 例经WT-2009 方案进行治疗的患儿中,CR 24 例(92%),PR 1例(4%),PD 1 例(4%);治疗过程中仅1 例发生严重肺部感染。预期2 年累积生存率为100%,2 年无事件生存率为89.7%。结论 肾母细胞瘤病理类型以预后良好型多见,化疗反应敏感;患儿对WT-2009 方案化疗耐受性好,无化疗相关死亡,安全性高。

Abstract:

Objective To evaluate the efficacy and safety of the WT-2009 chemotherapy protocol for Wilms' tumor (WT) in children. Methods The clinical data of 34 children with newly-diagnosed WT between July 2009 and December 2013 were retrospectively analyzed. Among the 34 children, 2 died before treatment, 6 children did not accept therapy and 26 accepted the chemotherapy based on the WT-2009 chemotherapy protocol. Kaplan-Meier method was used to estimate the 2-year survival rate. Results The pathological analysis revealed the favorable histology WT was common (88%, 30/34). The most common first manifestation was abdominal masses (56%, 19/34). Among the 26 patients who accepted the chemotherapy based on the WT-2009 protocol, complete remission was achieved in 24 cases (92%), partial remission was achieved in 1 case (4%), and disease relapse was found in 1 case (4%). Severe pulmonary infection occurred in 1 case in the course of treatment. The 2-year overall survival rate and event-free survival rate were 100% and 89.7% respectively. Conclusions Favorable histology is most common pathological type in children with WT. The chemotherapy based on the WT-2009 protocol for WT can produce a favorable prognosis and a high tolerance.