实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (3): 434-437.doi: 10.3969/j.issn.1672-5069.2026.03.029

• 肝癌 • 上一篇    下一篇

新辅助化疗后高频聚焦超声消融治疗小儿肝母细胞瘤疗效评价*

王栋, 刘延宝, 郭涛   

  1. 056009 河北省邯郸市 河北工程大学临床医学院临床医学系(王栋,刘延宝);附属医院儿科(郭涛)
  • 收稿日期:2025-01-15 出版日期:2026-05-10 发布日期:2026-05-18
  • 作者简介:王栋,男,26岁,硕士研究生。研究方向:肿瘤临床诊治研究。E-mail:15861990725@163.com
  • 基金资助:
    *河北省自然科学基金资助项目(编号:H2022109014)

Preoperative neoadjuvant chemotherapy followed by high-intensity focused ultrasound ablation in the treatment of children with hepatoblastoma

Wang Dong, Liu Yanbao, Guo Tao   

  1. Department of Clinical Medicine, Hebei University of Engineering Medical School, Handan 056009, Hebei Province, China
  • Received:2025-01-15 Online:2026-05-10 Published:2026-05-18

摘要: 目的 评估新辅助化疗方案后采取高频聚焦超声消融(HIFU)治疗小儿肝母细胞瘤(HB)的疗效。方法 2015年1月~2022年6月我院诊治的HB患儿26例,其中14例对照组接受CAO化疗方案治疗,另12例观察组则在CAO化疗后接受HIFU治疗,随访2年。结果 两组基线人口学、病灶直径和部位及血清甲胎蛋白水平比较,无显著性差异(P>0.05);观察组完全缓解、部分缓解、疾病稳定、客观缓解和疾病控制率分别为50.0%、25.0%、16.7%、75.0%和91.7%,与对照组的14.3%、28.6%、35.7%、42.8%和78.6%比,仅ORR存在显著性差异(P<0.05);在治疗期间,两组脱发、恶心呕吐、粒细胞减少、血小板减少、血红蛋白降低和窦性心律过速等不良反应发生率比较,无显著性差异(P>0.05);在随访2年末,观察组病死率为25.0%,与对照组的35.7%比,差异无统计学意义(P>0.05)。结论 采取新辅助化疗后实施HIFU治疗小儿HB可提高近期疗效,但对远期生存获益还需要继续观察。

关键词: 肝母细胞瘤, 新辅助化疗, 高频聚焦超声消融, 治疗

Abstract: Objective The purpose of this study was to evaluate efficacy of preoperative neoadjuvant chemotherapy followed by high-intensity focused ultrasound (HIFU) ablation in the treatment of children with hepatoblastoma (HB). Methods 26 children with HB were encountered in our hospital between January 2015 and June 2022, neoadjuvant chemotherapy were conducted in 14 children as for control, and HIFU after neoadjuvant chemotherapy were performed in another 12 children for observation. All children were followed-up for two years. Results There were no significant differences as respect to baseline demography, diameters and locations of tumors and serum alpha-fetoprotein levels between the two groups(P>0.05); complete remission, partial remission, stable disease, objective remission rate (ORR) and disease control rate (DCR) in the observation were50.0%, 25.0%, 16.7%, 75.0% and 91.7%, while they were 14.3%, 28.6%, 35.7%, 42.8% and 78.6% in the control, only ORR significantly different between the two groups (P<0.05); during period of antitumor therapy, there were no significant differences as respect to incidences of adverse effects, such as alopecia, nausea and vomiting, granulocytopenia, thrombocytopenia, hemoglobin reduction and sinus tachycardia between the two groups (P>0.05); by end of two-year follow-up, the mortality rates in the observation group was 25.0%, not significantly different as compared to 35.7% in the control group (P>0.05). Conclusion The strategy of HIFU ablation after neoadjuvant chemotherapy in treatment of children with HB is efficacious, which might improve short-term remission, while the long-term survival benefit needs further observation.

Key words: Hepatoblastoma, Neoadjuvant chemotherapy, High-intensity focused ultrasound, Ablation, Therapy