摘要
目的探讨影响儿童转移性髓母细胞瘤(MB)的预后相关因素。方法回顾性分析2012—2020年期间上海交通大学医学院附属新华医院肿瘤科收治的87例转移性MB患儿的临床特征与生存资料,采用Kaplan-Meier法生存分析,Cox模型多因素分析。结果87例转移性MB患儿中位发病年龄59个月(15~183个月),>3岁69例(79%),≤3岁18例(21%);男女比例1∶0.67;M1期5例(6%),M2期8例(9%),M3期74例(85%);手术至放疗的间隔中位时间为41d,≤49d 53例(61%),>49d 34例(39%);放疗总天数平均(47.2±14.3)d,≤49d 57例(66%),>49d 30例(34%)。患儿3年总生存和无进展生存率分别为57%和50%。单因素分析发现组织学分型、手术至放疗间隔时间、放疗总天数、放疗后是否化疗是影响总生存的因素(均P<0.05),多因素分析发现手术至放疗间隔时间、放疗后是否化疗是影响总生存的因素(均P<0.05)。结论儿童转移性MB的总体预后不佳,≤3岁患儿的预后较差。手术至放疗的间隔时间、放疗后是否化疗是影响患儿总体生存时间的独立预后因素。手术后尽早放疗及放疗后化疗可改善预后。
Objective To investigate the prognostic factors of metastatic medulloblastoma in children.Methods We retrospectively analyzed the clinical characteristics and survival data of 87 children with metastatic medulloblastoma treated in Xinhua Hospital between January 1,2012 and December 31,2020.Kaplan-Meier method and Cox regression method were used for survival analysis to investigate the influence of clinical factors on the prognosis of metastatic medulloblastoma.Results The median age of the 87 children with metastatic medulloblastoma was 59(15-183)months,69(79%)were>3 years,and 18(21%)were≤3 years;male to female ratio was 1 vs 0.67.Five patients(6%)were M1 stage,8 patients(9%)were M2 stage,and 74 patients(85%)were M3 stage.The median interval from surgery to radiotherapy was 41 days,53 patients(61%)were≤49 days,and 34 patients(39%)were>49 days.The total number of radiotherapy days averaged 47.2±14.3 days,57 patients(66%)were≤49 days,and 30 patients(34%)were>49 days.The 3-year OS and EFS of the children were 57%and 50%.Univariate analysis found that factors such as histological typing,interval between surgery and radiotherapy,total number of radiotherapy days,and whether chemotherapy was administered after radiotherapy had statistically significant effects on overall survival time(all P<0.05);Cox regression analysis identified that the interval between surgery and radiotherapy and whether chemotherapy was administered after radiotherapy were independent prognostic factors for overall survival time of children(all P<0.05).Conclusions The overall prognosis of metastatic medulloblastoma in children is dismal,with poorer outcomes in children≤3 years of age.The interval between surgery and radiotherapy,and whether chemotherapy was administered after radiotherapy were independent prognostic factors for overall survival time of children.Early radiotherapy after surgery and chemotherapy after radiotherapy can improve the prognosis.
作者
陈淑贤
石雪娇
周晴
周仁华
陆冬青
朱传营
李毅媛
蒋马伟
Chen Shuxian;Shi Xuejiao;Zhou Qing;Zhou Renhua;Lu Dongqing;Zhu Chuanying;Li Yiyuan;Jiang Mawei(Department of Oncology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《中华转移性肿瘤杂志》
2021年第4期260-265,共6页
Chinese Journal of Metastatic Cancer
作者简介
通信作者:蒋马伟,Email:jiangmawei@xinhuamed.com.cn
