[1]杨超,王珊,李长春,等.卵巢恶性生殖细胞瘤患儿62例治疗结果分析[J].第三军医大学学报,2012,34(18):1877-1880.
 Yang Chao,Wang Shan,Li Changchun,et al.Outcome of children with malignant ovarian germ cell tumor: a report of 62 cases[J].J Third Mil Med Univ,2012,34(18):1877-1880.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
34卷
期数:
2012年第18期
页码:
1877-1880
栏目:
论著
出版日期:
2012-09-30

文章信息/Info

Title:
Outcome of children with malignant ovarian germ cell tumor: a report of 62 cases
作者:
杨超王珊李长春章均孔祥如赵珍珍
重庆医科大学附属儿童医院肿瘤外科
Author(s):
Yang Chao Wang Shan Li Changchun Zhang Jun Kong Xiangru Zhao Zhenzhen
Department of Pediatric Surgical Oncology, Children’s Hospital, Chongqing Medical University, Chongqing, 400014, China
关键词:
儿童恶性生殖细胞肿瘤化疗生存率
Keywords:
pediatrics malignant ovarian germ cell tumor chemotherapy survival rate
分类号:
R181.32;R730.5;R737.31
文献标志码:
A
摘要:
目的      总结卵巢恶性生殖细胞瘤患儿的临床表现,综合治疗的效果,探讨其治疗策略。      方法        回顾性分析我院肿瘤外科2001年1月至2009年12月收治的62例卵巢恶性生殖细胞瘤患儿临床表现、治疗过程及随访情况。      结果        腹痛、腹胀为最常见临床表现。93.5%患儿血清AFP升高。33例患儿直接行手术+辅助化疗,27例患儿采用新辅助化疗+手术+辅助化疗治疗,2例Ⅳ期患儿未行手术。6例患者化疗无效进展死亡。全组3年总生存率为90.3%;Ⅰ/Ⅱ期患者3年生存率为100.0%,Ⅲ期为90.0%,Ⅳ期为71.4%,复发生存率为71.4%。48例青春期患儿中41例有规律月经周期,6例月经紊乱,1例需要激素替代治疗。      结论        采用手术联合含铂类药物化疗能明显改善儿童青少年生殖细胞瘤的疗效和生存率,对Ⅳ期、复发转移的恶性生殖细胞瘤患儿应探讨新的方案和增加剂量强度。保守手术后大多数患儿无需激素替代治疗。其远期生育能力尚需继续观察。
Abstract:
Objective      To analyze the clinical characteristics and treatment outcome of children with malignant ovarian germ cell tumor, and to investigate the therapeutic strategy.       Methods      Clinical manifestations, treatment outcome and follow-up data of 62 children with malignant ovarian germ cell tumor in our department from Jan. 2001 to Dec. 2009 were analyzed.       Results       Abdominal pain and abdominal distension were the most common clinical manifestations. Elevated alpha fetal protein (AFP) was observed in 93.5% patients. Surgery+adjuvant chemotherapy was applied in 33 patients. Twenty-seven patients received neoadjuvant chemotherapy+surgery+adjuvant chemotherapy, and 2 stage Ⅳ patients received chemotherapy alone. Six patients had poor response to chemotherapy and died of disease progression. The overall 3-year survival rate was 90.3%. The 3-year survival rate was 100% for stage Ⅰ-Ⅱ patients, 83.3% for stage Ⅲ patients, 65.6% for stage Ⅳ patients, and 66.7% for relapsed patients. Forty-one out of 48 patients in puberty age had regular menstrual cycles, 6 patients had menstrual disorder, and 1 patient required hormone replacement therapy during the follow-up period.       Conclusion      The prognosis of malignant ovarian germ cell tumor is favorable. Surgery combined with platinum-containing chemotherapy can improve the efficacy and survival of the patients. Further investigation on novel and high-dose chemotherapy regimens is needed for the patients with stage Ⅳ, relapsed, and metastatic tumors. Sex hormone replacement therapy is not necessary for most patients received fertility-preserving surgery. The long-term potentia generandi of these patients needs further investigation.

参考文献/References:

杨超, 王珊, 李长春, 等. 卵巢恶性生殖细胞瘤患儿62例治疗结果分析[J].第三军医大学学报,2012,34(18):1877-1880.

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更新日期/Last Update: 2012-09-18