论文部分内容阅读
目的探讨儿童泌尿生殖系统横纹肌肉瘤(RMS)的诊断和治疗方法。方法回顾性研究1978年6月-2010年3月本院收治的17例泌尿生殖系统RMS患儿的临床资料。患儿均采用以手术为主,联合术前术后化疗、放疗的治疗方法。采用SPSS13.0软件进行统计学处理,运用Kaplan-Meier曲线进行生存率分析。结果本组患儿中肿瘤来源于膀胱10例、前列腺5例、阴道2例。手术行肿瘤根治性切除加膀胱全切5例,肿瘤根治性切除加膀胱部分切除7例,肿瘤姑息性切除1例,活检4例。术后病理诊断胚胎型16例,腺泡型1例。根据美国RMS协作组(IRS)标准进行术后分期,Ⅰ期6例,Ⅱ期5例,Ⅲ期4例,Ⅳ期2例。术前化疗3例,术后化疗9例。术后放疗1例。手术完整切除率70.1%(12/17例),膀胱保存率58.3%(7/12例)。Kaplan-Meier生存率曲线图分析,本组预期存活时间(14.025±3.484)个月,2a生存率37.5%。结论泌尿生殖系统RMS治疗必须兼顾生命和保全器官功能。手术联合术前术后化疗及术后放疗可以提高患者生存率。
Objective To investigate the diagnosis and treatment of urinary and rhabdomyosarcoma (RMS) in children. Methods The clinical data of 17 patients with genitourinary system RMS admitted to our hospital from June 1978 to March 2010 were retrospectively studied. Children are used to surgery, combined with preoperative and postoperative chemotherapy, radiotherapy treatment. Using SPSS13.0 software for statistical analysis, the use of Kaplan-Meier curve for survival analysis. Results The tumors in this group originated from 10 cases of bladder, 5 cases of prostate and 2 cases of vagina. Surgical resection plus radical resection of the bladder in 5 cases, radical resection of the tumor plus partial resection of the bladder in 7 cases, palliative resection of the tumor in 1 case and biopsy in 4 cases. Postoperative pathological diagnosis of embryo in 16 cases, acinar in 1 case. According to the standard of American RMS collaborative group (IRS), there were 6 cases in stage Ⅰ, 5 cases in stage Ⅱ, 4 cases in stage Ⅲ and 2 cases in stage Ⅳ. 3 cases of preoperative chemotherapy, postoperative chemotherapy in 9 cases. Postoperative radiotherapy in 1 case. The complete resection rate was 70.1% (12/17 cases) and the bladder preservation rate was 58.3% (7/12 cases). Kaplan-Meier survival curve analysis, the expected survival time (14.025 ± 3.484) months, 2a survival rate of 37.5%. Conclusions RMS treatment of the genitourinary system must take into account both life and preservation of organ function. Surgery combined with preoperative and postoperative chemotherapy and postoperative radiotherapy can improve patient survival.