临床儿科杂志 ›› 2024, Vol. 42 ›› Issue (12): 1032-1038.doi: 10.12372/jcp.2024.24e0019

• 论著 • 上一篇    下一篇

AVDC/ICE方案治疗10例儿童颅外恶性横纹肌样瘤的临床疗效分析

封淑月, 张姮, 孙梦娇, 方拥军()   

  1. 南京医科大学附属儿童医院血液肿瘤科(江苏南京 210003)
  • 收稿日期:2024-01-06 出版日期:2024-12-15 发布日期:2024-12-02
  • 通讯作者: 方拥军 电子信箱:fyj322@126.com
  • 基金资助:
    江苏省卫生健康委员会2020年度医学科研立项项目(ZDB2020018)

Clinical efficacy analysis of AVDC/ICE regimen in the treatment of 10 pediatric extracranial malignant rhabdoid tumors

FENG Shuyue, ZHANG Heng, SUN Mengjiao, FANG Yongjun()   

  1. Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing 210003, Jiangsu, China
  • Received:2024-01-06 Published:2024-12-15 Online:2024-12-02

摘要:

目的 探讨AVDC/ICE方案治疗儿童颅外恶性横纹肌样瘤(MRT)的疗效。方法 对2020年1月至2023年1月接受AVDC/ICE方案治疗的10例颅外MRT患儿进行回顾性分析。结果 10例颅外MRT患儿,男女发病比例为1∶1,中位发病年龄为24.5(1~138)月龄。3例患儿初诊时发生远处转移,最常见的转移部位是肺。初诊肿瘤平均大小为(9.87±5.42) cm。2例肾恶性横纹肌样瘤(MRTK)患儿术前出现肿瘤破溃。10例患儿明确病理后均接受AVDC/ICE方案化疗。截至末次随访时间,7例患儿处于完全缓解(CR)状态,1例患儿处于部分缓解(PR)状态,目前予贝伐珠单抗+索拉菲尼+环磷酰胺维持治疗中。2例肾外非中枢神经系统恶性横纹肌样瘤(EERT)患儿死于肿瘤转移。中位随访时间为14(5~28)个月,1年总体生存率(OS)为78.8%,1年无事件生存率(EFS)为68.6%。10例患儿治疗过程中均未发生与治疗相关的严重不良事件。结论 AVDC/ICE方案是治疗儿童颅外MRT安全有效的化疗选择。

关键词: 恶性横纹肌样瘤, 治疗, 预后, 儿童

Abstract:

Objective This study aims to assess the therapeutic effectiveness of the AVDC/ICE regimen for children diagnosed with extracranial malignant rhabdoid tumors (MRT). Methods A retrospective analysis was conducted on 10 pediatric cases of extracranial MRT treated with the AVDC/ICE from January 2020 to January 2023. Results Clinical data from 10 pediatric patients with extracranial MRT were analyzed. The gender distribution was balanced (1:1), with a median age at diagnosis of 24.5 months (range 1-138 months). Three patients had distant metastases at diagnosis, predominantly in the lungs. The average size of primary tumors at diagnosis was (9.87±5.42) cm. Two patients with malignant rhabdoid tumor of the kidney (MRTK) experienced tumor rupture before surgery. Following pathological confirmation, all patients received the AVDC/ICE chemotherapy regimen. At the last follow-up, seven patients achieved complete remission (CR), one patient achieved partial remission (PR) and was receiving maintenance therapy with bevacizumab, sorafenib, and cyclophosphamide. Two patients with extra-renal extracranial rhabdoid tumor (EERT) succumbed to metastasis. The median follow-up was 14 months (range 5-28 months), with a one-year overall survival (OS) rate of 78.8% and a one-year event-free survival (EFS) rate of 68.6%. No severe treatment-related adverse events were observed. Conclusion The AVDC/ICE regimen emerges as a safe and effective chemotherapy option for managing extracranial MRT in pediatric patients.

Key words: extracranial malignant rhabdoid tumors, treatment, prognosis, child