【摘要】 目的探讨多学科协助模式在幼儿肝母细胞瘤诊治中的应用价值。方法回顾性分析2014年4月至2017年5月湖南省人民医院收治的8例经多学科综合诊治的肝母细胞瘤患儿的临床资料。观察指标:(1)治疗前病变范围(PRETEXT)分期、手术情况;(2)病理组织学特点,术后化疗方案;(3)随访患儿中位生存时间、无瘤生存率、总体生存时间。采用门诊和电话方式进行随访。结果 8例患儿均经过多学科讨论,术前PRETEXT分期,Ⅰ期1例,Ⅱ期3例,Ⅲ期3例,Ⅳ期1例;术后病理结果,3例为单纯胎儿型肝母细胞瘤,5例为混合型肝母细胞瘤。术后1个月开始接受顺铂联合多柔比星化疗,共4个周期。随访时间4~40个月,中位随访时间为21.5个月,所有患儿均为无瘤生存。结论根治性手术切除是治疗儿童肝母细胞瘤的基础,多学科综合诊治可为肝母细胞瘤患儿制定个体化治疗方案。更多还原

【Abstract】 objective To investigate the value of Multi-Disciplinary Team modality in the diagnosis and treatment of hepatobastoma in children. Methods The clinical data of 8 patients with hepatoblastoma treated in Hunan Provincial People’s Hospital from Apr. 2014 to May 2017 were analyzed retrospectively. Observation indicators:(1)The PRETEXT staging and operation situations;(2)Histopathological features and postoperative chemotherapy protocols;(3)Follow up: median survival time, disease-free survival rate, overall survival time. Patients were followed-up by outpatient examination and telephone interviews. Results All 8 cases underwent multi-disciplinary discussion. The preoperative PRETEXT staging showed 1 case of stage Ⅰ, 3 cases of stage Ⅱ, 3 cases of stage Ⅲ and 1 case of stage Ⅳ. Postoperative pathological examination showed that 3 cases were pure fetal hepatobastoma and 5 cases were mixed type of hepatobastoma. Cisplatin combined with doxorubicin chemotherapy was performed for 4 cycles 1 months after surgery. The patients were followed-up for 4 to 40 months, the median follow-up time was 21.5 months. All patients were disease-free survival. Conclusion Radical resection is the basis of treatment for hepatoblastoma in children. Multi-Disciplinary Team modality can provide a better treatment for children with hepatobastoma.更多还原