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目的有效实施儿童实体瘤的诊断治疗计划 ,提高儿童实体瘤的疗效。方法建立由外科、肿瘤内科、放疗科、病理科、影像学科为基本组成的多学科协作小组 ,前瞻性设计诊断治疗方案 ,小组成员既分工又充分合作 ,对65例儿童实体瘤病人按方案及时实施合理的诊断和治疗步骤。结果肾母细胞瘤26例 ,神经母细胞瘤21例 ,Ⅲ～Ⅳ期其他实体瘤18例 ,共65例病儿均得到明确的病理诊断与分型 ,并得到明确的分期或临床分组。65例中63例按时按期进入相应的治疗方案。26例肾母细胞瘤中获完全缓解24例 (92.30 % ) ,其中延迟手术肿瘤完全切除1例 ;缓解24月复发获再次缓解1例 ;平均无病生存30个月 (10～53个月 )24例 ,占92.30 %。神经母细胞瘤21例 ,获完全缓解15例 ,缓解率为71.42 % ,其中10例为化疗后延迟手术肿瘤完全切除 ;获随访18例 ,无病生存11～52个月11例 (61.11% ) ,平均32个月。其他Ⅲ～Ⅳ期实体瘤 (横纹肌肉瘤、尤文氏肉瘤和生殖细胞性恶性肿瘤 )共18例 ,获完全缓解15例 (83.33 %) ;无病生存13～53个月11例 ,占61.11 %,平均29个月。结论多学科协作的工作方式及所采用的诊断治疗方案对儿童实体瘤有效 ,值得推广。
Objective To effectively implement the diagnosis and treatment plan of solid tumors in children and improve the curative effect of solid tumors in children. Methods A multidisciplinary collaborative group consisting of surgery, oncology, radiotherapy, pathology and imaging was established prospectively to design and diagnose the treatment plan. The group members were both divided and cooperated fully, and 65 cases of children with solid tumors were treated according to the schedule Implement reasonable diagnostic and treatment procedures. Results 26 cases of nephroblastoma, 21 cases of neuroblastoma, 18 cases of other solid tumors in stage Ⅲ ~ Ⅳ, a total of 65 cases of children were confirmed pathological diagnosis and classification, and a clear staging or clinical grouping. 63 cases of 65 cases on schedule to enter the corresponding treatment schedule. In 26 cases of nephroblastoma, 24 cases were completely relieved (92.30%), of which 1 case was delayed complete tumor resection, 1 case was alleviated in 24 months relapse and 30 months (10-53 months) 24 cases, accounting for 92.30%. 21 cases of neuroblastoma achieved complete remission in 15 cases, the response rate was 71.42%, of which 10 cases were delayed surgery after complete resection of the tumor; 18 cases were followed up for 11 to 52 months (11.11% , An average of 32 months. The other Ⅲ ~ Ⅳ solid tumors (rhabdomyosarcoma, Ewing’s sarcoma and germ cell malignancies) were 18 cases, complete remission in 15 cases (83.33%); disease-free survival of 13 to 53 months in 11 cases, accounting for 61.11% Average 29 months. Conclusions The multidisciplinary approach to work and the diagnostic treatment used are effective for solid tumors in children and are worthy of promotion.