62例卵巢恶性生殖细胞瘤治疗结果分析.doc

62例卵巢恶性生殖细胞瘤治疗结果分析 杨 超，王 珊，李长春，章 均，孔祥如，赵珍珍 （400014，重庆，重庆医科大学附属儿童医院肿瘤外科） [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, 并探讨其治疗策略。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, 其余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期/Ⅱ期患者 3 年生存率为 100%, Ⅲ期为 90%,Ⅳ期为 71.4%, 复发患者为 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 卵巢恶性生殖细胞肿瘤临床表现无特异性。肿瘤标志物检查有助于提高该病诊断率。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者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，性激素水平正常。其远期生育能力尚需继续观察。 [关键词] 儿童；恶性生殖细胞肿瘤；化疗；生存率 [中图法分类号] R737 [文献标志码] A Treatment Outcome of Children with malignant Germ Cell Tumor--A Report of 62 Cases Yang Chao, Wang Shan , Li Changchun, Zhang Jun , Kong Xiangru, Zhao Zhenzhen(Department of Pediatric surgical oncology, Children’s Hospital of Chongqing Medical University, Chongqing, China) [Abstract] Objective This study was to analyze the clinical characteristics and treatment outcome of children with malignant ovarian germ cell tumor, and to investigate the therapeutic strategy. Methods Clinical characteristics, treatment outcome and follow-up of 62 children with malignant ovarian germ cell tumor, treated in Surgical oncology department of Chongqing medical university from Jan. 2001 to Dec. 2009, were analyzed. Results Abdominal pain and abdominal distension were the most clinical presentations. Elevated AFP was observed in 93.5% cases. Surgery + adjuvant chemotherapy was applied in 33 patients, other 27 patients received neoadjuvant chemotherapy + Surgery + adjuvant chemotherapy, 2 stage Ⅳ patients received chemotherapy alone. 6 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 stageⅠ-Ⅱ patients , 83.3% for stage Ⅲ patients , 65.6% for stage Ⅳ patients , and 66.7% for relapsed patients. 41 out of 48 patients in puberty age have regular menstrual cycles. 6 p