摘要
目的观察采用高强度聚焦超声(HIFU)消融联合化疗治疗中晚期肝母细胞瘤(HB)患儿的5年随访疗效。方法2013年8月~2017年2月我院诊治的41例中晚期HB患儿,其中18例对照组患儿接受CAO化疗方案治疗,另23例在化疗治疗结束后,行HIFU消融治疗。随访5年。使用流式细胞仪检测外周血CD3^(+)、CD4^(+)、CD8^(+)细胞百分比。结果观察组有效率和疾病控制率分别为65.2%和87.0%,显著高于对照组的33.3%和55.6%(P<0.05);治疗后,观察组外周血CD4^(+)细胞百分比和CD4^(+)/CD8^(+)细胞比值分别为(42.5±3.9)%和(1.6±0.4),均显著高于对照组【分别为(39.4±3.5)%和(1.3±0.3),P<0.05】,而CD3^(+)和CD8^(+)细胞百分比分别为(55.4±5.2)%和(26.1±2.4)%,均显著低于对照组【分别为(60.1±5.9)%和(30.0±2.8)%,P<0.05】;观察组不良反应发生率为34.8%,与对照组的33.3%比,无显著性差异(P>0.05);观察组1 a、3 a和5 a生存率分别为100.0%(21/21)、71.4%(15/21)和28.6%(6/21),对照组分别为100.0%(17/17)、41.2%(7/17)和11.8%(2/17),两组无显著性差异(Log-Rank=3.160,P=0.075)。结论采用HIFU消融联合化疗治疗HB患儿可以取得一定的临床效果,但进行消融治疗的益处还需要研究。
Objective The aim of this study was to observe the long-term efficacy of high intensity focused ultrasound(HIFU)ablation and chemotherapy in the treatment of children with advanced hepatoblastoma(HB).Methods 41 children with advanced HB were encountered in our hospital between August 2013 and February 2017,and were divided into control(n=18)and observation group(n=23),receiving CAO chemotherapy,or HIFU ablation after chemotherapy.All the children were followed-up for five years.The percentages of peripheral blood CD3^(+),CD4^(+),CD8^(+)cells were determined by FCM.Results The effective rate and disease control rate in the observation group were 65.2%and 87.0%,both much higher than 33.3%and 55.6%(P<0.05)in the control;3 months after treatment,the percentages of CD4^(+)cells and the ratio of CD4^(+)/CD8^(+)cells in the observation group were(42.5±3.9)%and(1.6±0.4),both significantly higher than[(39.4±3.5)%and(1.3±0.3),respectively,P<0.05],while the percentages of CD3^(+)cells and CD8^(+)cells were(55.4±5.2)%and(26.1±2.4)%,both significantly lower than[(60.1±5.9)%and(30.0±2.8)%,respectively,P<0.05]in the control group;the incidence of untoward effect in the observation group was 34.8%,not significantly different compared to 33.3%in the control(P>0.05);the one-year,three-year and five-year survival rates in the observation group were 100.0%(21/21),71.4%(15/21)and 28.6%(6/21)as two lost visit,also not significantly different as compared to 100.0%(17/17),41.2%(7/17)and 11.8%(2/17)as one lost visit(Log-Rank=3.160,P=0.075)in the control group.Conclusion The HIFU ablation and chemotherapy has a clinical efficacy in the treatment of children with HB,which should be carefully investigated in the future.
作者
青秀
周沙
刘斌
Qing Xiu;Zhou Sha;Liu Bin(Department of Paediatrics.Affiliated Hospital,Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《实用肝脏病杂志》
CAS
2023年第6期911-914,共4页
Journal of Practical Hepatology
基金
四川省科技厅指导性科技计划项目(编号:20200124)。
关键词
肝母细胞瘤
化疗
高强度聚焦超声消融
治疗
小儿
Hepatoblastoma
Chemotherapy
High intensity focused ultrasound ablation
Therapy
Children
