儿童横纹肌肉瘤临床综合治疗疗效

　　Clinical efficacy of comprehensive treatment in children with rhabdomyosarcoma

　　儿童横纹肌肉瘤临床综合治疗疗效

　　Abstract：Objective To study diagnosis and treatment of rhabdomyosarcoma (RMS) in children.Method The clinical data of 43 children with RMS was retrospectively reviewed from Nov 2004 to May 2012.Their long-term survival was followed up.Forty-three children with RMS(male 26,female 17) in Beijing Tongren Hospital were enrolled.Their median age on diagnosis was 6 years old.We confirmed the diagnosis according to pathological diagnosis.Comprehensive treatment included chemotherapy,surgery and implantation of radioactive seeds,and so on.Statistical analysis was used on clinical data and treatment efficacy.Result The median follow up time of 43 cases with RMS in children was 31 mouths until May 2012.Four cases abandoned,39 cases were followed up.The cases of complete remission were 27(69%),and the cases of partly remission were 7 (18%),and the cases of dead were 5 due to cerebral metastasis.Overall survival rate was 87% (34/39).Eight cases were treated with 125Ⅰ particles implants into its location,7 cases responded,1 case was invalid.Conclusion Although anatomic structure of RMS of head and neck was very complex,and the prognosis of it with metastatic disease was inferior,the muttidisciplinary treatment can still improve the clinical remission rate.In particular,high risk RMS with 125Ⅰ particles implants and large dose chemotherapy would be

　　摘要：探讨儿童横纹肌肉瘤诊治。方法分别回顾北京同仁医院收治的43例儿童患者资料从2004年11月到2012年5月。综合治疗采用规律化疗、手术治疗及放射性粒子植入术等综合治疗。对临床数据及治疗进行统计分析。结果 43例人平均随访时间31个月直到2012年5月。 4例失访，39例一直随访中。 完全缓解27例(69%)，部分缓解7 例(18%) ，脑转移死亡5例。 总生存率87% (34/39)。 8例头颈部患儿行125Ⅰ放射性粒子组织间植入，7例有反应，1例无反应。结论对于儿童头颈部RMS应提倡多学科综合治疗。特别是125Ⅰ粒子组织间植入，大剂量的化疗提高缓解率。