CAO方案化疗联合高频聚焦超声消融治疗Ⅲ/Ⅳ期肝母细胞瘤患儿疗效分析*

doi:10.3969/j.issn.1672-5069.2019.04.030

摘要/Abstract

摘要： 目的分析应用长春新碱、阿表霉素联合环磷酰胺（CAO方案）化疗联合高频聚焦超声消融治疗Ⅲ/Ⅳ期肝母细胞瘤（HB）患儿的疗效。方法回顾性分析2010年12月~2016年1月我科收治的34例Ⅲ/Ⅳ期HB患儿的临床资料,其中16例接受CAO方案化疗联合高频聚焦超声消融治疗,18例仅接受CAO方案化疗治疗。比较两组各项血和生化指标、肿瘤缓解率、化疗不良反应发生率和转归情况。结果在治疗3 m末,联合组血清AFP水平为（43.2±5.4） μg/L,ALT水平为（93.5±26.3） U/L,AST水平为（91.2±30.2） U/L,显著低于对照组【分别为（55.3±6.2） μg/L、（197.1±57.8） U/L和（213.7±66.2） U/L,P<0.05】,而两组外周血Hb水平比较,差异无统计学意义（P>0.05）;联合组肿瘤缓解率为81.3%,显著高于对照组的61.1%,差异具有统计学意义（P<0.05）;联合组化疗不良反应发生率为18.8%,与对照组的27.8%比,差异无统计学意义（P>0.05）;在随访24 m末,联合组病死率为6.3%,与对照组的11.1%比,差异无统计学意义（P>0.05）,但联合组肿瘤复发率为13.3%,显著低于对照组的25.0%,差异具有统计学意义（P<0.05）。结论采取CAO方案化疗与高频聚焦超声消融联合治疗Ⅲ/Ⅳ期HB患儿能有效延缓病情发展,提高肿瘤缓解率,降低复发率。

关键词: 肝母细胞瘤, 化疗, 高频聚焦超声消融, 应答, 生存

Abstract: Objective To investigate the efficacy of combination of vincristine,apixamycin and cyclophosphamide （CAO chemotherapy regimen） combined with high frequency focused ultrasound ablation in the treatment of children with hepatoblastoma （HB） at stage III/IV.Methods The clinical data of 34 children with HB at stage III and IV recruited in our hospital between December 2010 and January 2016 were analyzed retrospectively. Out of them,16 patients t were treated with combination of CAO chemotherapy regimen and high-frequency focused ultrasound ablation,and 18 patients were treated with CAO chemotherapy regimen alone. All the children were followed-up for 24 months. The biochemical indicators,tumor relief,adverse reactions of chemotherapy and the outcomes of patients were compared between the two groups.Results At the end of three-month treatment,serum AFP level in the combination group was （43.2±5.4） μg/L,serum ALT level was （93.5±26.3） U/L,and serum AST level was （91.2±30.2） U/L,significantly lower than （55.3±6.2） μg/L,（197.1±57.8） U/L and （213.7±66.2） U/L in the control （P<0.05）,while blood Hb levels in the two groups were not significantly different （P>0.05）;the tumor remission rate in the combination group was 81.3%,significantly higher than 61.1% in the control （P<0.05）;the incidence of side effect in the combination was 18.8%,not significantly different compared to 27.8% in the control （P>0.05）;at the end of 24 month followed-up,the fatality rate in the combination group was 6.3%,not significantly different compared to 11.1% in the control（P>0.05）,however,the recurrence rate of intrahepatic tumor was 13.3% in combination group,significantly lower than 25.0% in the control（P<0.05）. Conclusion The CAO chemotherapy regimen combined with high-frequency focused ultrasound ablation in the treatment of children with stage III and IV HB might be efficient,which delay the tumor growth and reduce the recurrence rate after treatment.

Key words: Hepatoblastoma, Chemotherapy, High-frequency focused ultrasound ablation, Response, Survival

黄仕颖, 梁爽, 魏杨辉, 傅绢, 邓凤平, 金仙梅. CAO方案化疗联合高频聚焦超声消融治疗Ⅲ/Ⅳ期肝母细胞瘤患儿疗效分析^*[J]. 实用肝脏病杂志, 2019, 22(4): 569-572.

Huang Shiying, Liang Shuang, Wei Yanghui, et al. Efficacy of CAO chemotherapy regimen combined with high frequency focused ultrasound ablation in the treatment of children with hepatoblastoma at stage III/IV[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(4): 569-572.

参考文献

[1] 靳丽嘉. 超声造影在不同分化程度原发性小肝癌诊断中的临床价值. 实用癌症杂志,2017,32(5):850-852.
[2] Yuan XJ,Wang HM,Jiang H,et al.Multidisciplinary effort in treating children with hepatoblastoma in China. Cancer Lett,2016,375(1):39-46.
[3] Von Schweinitz D,Faundez A,Teichmann B,et al.Hepatocyte growth-factor-scatter factor can stimulate post-operative tumor-cell proliferation in childhood hepatoblastoma. Int J Cancer,2015,85(2):151-159.
[4] Joshi VV,Kaur P,Ryan B,et al.Mucoid anaplastic hepatoblastoma. A case report. Cancer,2015,54(9):2035-2039.
[5] Wang S,Yang C,Zhang J,et al.First experience of high-intensity focused ultrasound combined with transcatheter arterial embolization as local control for hepatoblastoma. Hepatology,2014,59(1):170-177.
[6] 陈加平,郭春宝,张明满. 儿童Ⅲ、Ⅳ期肝母细胞瘤化疗联合高强度聚焦超声消融术与化疗的疗效对比. 中华小儿外科杂志,2015,36(1):26-31.
[7] Gao LZ,Gao EM,Bai YF,et al.Hyperthermic intraperitoneal chemotherapy plus high-frequency diathermic therapy followed by intravenous chemotherapy versus intravenous chemotherapy alone for postoperative adjuvant treatment of gastrointestinal cancer:a comparative research study. J Buon,2016,21(6):1510-1517.
[8] 王天怡,潘慈,汤静燕,等. 儿童肝母细胞瘤74例随访研究. 中华儿科杂志,2017,55(5):364-368.
[9] Halliburton G,Murad HY,Kala M,et al.In vivo investigation of high-intensity focused ultrasound combined with thermally triggered chemotherapy for liver cancer treatment. J Acoust Soc Am,2017,142(4):2720-2721.
[10] Conrad RJ,Gribbin D,Walker NI,et al.Combined cystic teratoma and hepatoblastoma of the liver. Probable divergent differentiation of an uncommitted hepatic precursor cell. Cancer,2015,72(10):2910-2913.
[11] 汤梦婕,袁晓军,谈珍,等. 多学科综合治疗47例儿童肝母细胞瘤的疗效评估. 中华实用儿科临床杂志,2016,31(15):1175-1179.
[12] Mi HY,Lee JY,Kim HR,et al.Therapeutic effects of microbubbles added to combined high-intensity focused u1trasound and chemotherapy in a pancreatic cancer xenograft model. Kor J Radiol,2016,17(5):779-788.
[13] Wang M,Yuan W,Jiang X,et al.Disruption of microalgal cells using high-frequency focused ultrasound. Biores technol,2014,153(2):315-321.
[14] Park WS,Ra Oh R,Young Park J,et al.Nuclear localization of beta-catenin is an important prognostic factor in hepatoblastoma. J Pathol,2015,193(4):483-490.
[15] Napoli VM,Jr CW.Hepatoblastoma in infant sister and brother. Cancer,2015,39(6):2647-2650.
[16] Quinn JJ,Altman AJ,Robinson HT,et al.Adriamycin and cisplatin for hepatoblastoma. Cancer,2015,56(8):1926-1929.
[17] Hata Y,Ishizu H,Ohmori K,et al.Flow cytometric analysis of the nuclear DNA content of hepatoblastoma. Cancer,2015,68(12):2566-2570.
[18] Tao J,Calvisi DF,Ranganathan S,et al.Activation of β-catenin and yap1 in human hepatoblastoma and induction of hepatocarcinogenesis in mice. Gastroenterology,2014,147(3):690-701.
[19] Rahman TM,Selden C,Khalil M,et al.Alginate-encapsulated human hepatoblastoma cells in an extracorporeal perfusion system improve some systemic parameters of liver failure in a xenogeneic model. Artif Org,2015,28(5):476-482.
[20] Bell B,Ranganathan S,Tao JY,et al.Novel Advances in Understanding of Molecular Pathogenesis of Hepatoblastoma:A Wnt/β-Catenin Perspective. Gene Expr,2017,17(2):141-154.
[21] Rikhi RR,Spady KK,Hoffman RI,et al.Hepatoblastoma:A Need for Cell Lines and Tissue Banks to Develop Targeted Drug Therapies. Front Pediatr.2016;4:22.

CAO方案化疗联合高频聚焦超声消融治疗Ⅲ/Ⅳ期肝母细胞瘤患儿疗效分析^*

Efficacy of CAO chemotherapy regimen combined with high frequency focused ultrasound ablation in the treatment of children with hepatoblastoma at stage III/IV

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