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中国循证儿科杂志

中国循证儿科杂志 ›› 2022, Vol. 17 ›› Issue (6): 426-431.DOI: 10.3969/j.issn.1673-5501.2022.06.004

• 论著 • 上一篇    下一篇

北京市多中心青少年恶性实体肿瘤临床特征和预后的横断面调查

苏雁1a,8,黄真2,8,陆峥3,8,李苗4,8,支天5,8,孙青6,8,张朝霞7,8,王焕民1b,葛明1c,于彤1d,何乐健1e,刘嵘7,赵卫红6,黄东生5,武万水4,宫剑3,牛晓辉2,马晓莉1a

  

  1. 1 首都医科大学附属北京儿童医院 北京，100045，a儿童肿瘤中心，肿瘤内科，b肿瘤外科，c神经外科，d影像中心，e病理科；2 首都医科大学附属北京积水潭医院骨肿瘤科 北京，100035；3 首都医科大学附属北京天坛医院小儿神经外科 北京，100070；4 首都医科大学附属北京世纪坛医院儿科 北京，100038；5 首都医科大学附属北京同仁医院儿科 北京，100730；6 北京大学第一医院儿科 北京，100034；7 北京儿科研究所附属儿童医院血液科 北京，100020；8 共同第一作者
  • 收稿日期:2022-05-20 修回日期:2022-11-09 出版日期:2022-12-25 发布日期:2022-12-25
  • 通讯作者: 苏雁；牛晓辉；宫剑；武万水；黄东生；赵卫红；刘嵘

Clinical features and prognosis in adolescents with malignant solid tumors in Beijing: A multicenter cross-sectional survey

SU Yan1a,8, HUANG Zhen2,8, LU Zheng3,8, LI Miao4,8, ZHI Tian5,8, SUN Qing6,8, ZHANG Zhaoxia7,8, WANG Huanmin1b, GE Ming1c, YU Tong1d, HE Lejian1e, LIU Rong7, ZHAO Weihong6, HUANG Dongsheng5, WU Wanshui4, GONG Jian3, NIU Xiaohui2, MA Xiaoli1a   

  1. 1 Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China, a. Pediatric Oncology Center, Medical Oncology Department, b. Department of Surgical Oncology, c. Department of Neurosurgery, d. Imaging Center, e. Department of Pathology; 2 Department of Orthopedic Oncology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China; 3 Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 4 Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 5 Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;6 Department of Pediatrics, Peking University First Hospital, Beijing 100034, China; 7 Department of Hematology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China; 8 Co-first author
  • Received:2022-05-20 Revised:2022-11-09 Online:2022-12-25 Published:2022-12-25
  • Contact: SU Yan; NIU Xiaohui; GONG Jian; WU Wanshui; HUANG Dongsheng; ZHAO Weihong; LIU Rong

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摘要： 目的：总结北京地区多中心诊治的青少年恶性实体肿瘤的临床特征及预后。 设计：横断面调查。 方法：回顾性分析2010年1月1日至2019年12月31日北京地区7家医院确诊的且当时年龄≥10岁的恶性实体肿瘤初发患儿的临床特征和预后。 主要结局指标：3年无事件生存率（EFS）和总生存率（OS）。 结果：共411例恶性实体肿瘤患儿纳入分析，中位年龄150（120~216）月，男239例（58.2%），女172例。中枢神经系统肿瘤183例（44.5%），尤文肉瘤82例（20.0%），横纹肌肉瘤47例（11.4%），神经母细胞瘤33例（8.0%），非横纹肌肉瘤类软组织肉瘤29例（7.1%），颅外生殖细胞肿瘤18例（4.4%），其他肿瘤19例（4.6%）。411例恶性实体肿瘤患儿中，前3位户籍来自华北地区160例（38.9%），华东地区97例（23.6%），中南地区70例（17.0%）。治疗涉及1家、2家和≥3家医院患儿分别有129例（31.4%）、180例（43.8%）和102例（24.8%）。截至末次随访时间2020年6月30日，411例恶性实体肿瘤患儿中位随访时间26（1~120）个月，生存333例（81.0%），死亡78例，发生肿瘤复发/进展145例（35.3%）。3年总体EFS为 60.3%，以中枢神经系统肿瘤最高（73.7%），横纹肌肉瘤最低（37.4%）；3年总体OS为79.5%，以中枢神经系统肿瘤最高（87.9%）。78例死亡病例中位生存时间13（1~65）个月，其中中枢神经系统肿瘤22例（28.2%），横纹肌肉瘤18例（23.1%），尤文肉瘤16例（20.5%），神经母细胞瘤8例（10.3%），颅外恶性生殖细胞瘤3例（3.8%），非横纹肌肉瘤类软组织肉瘤5例（6.4%），其他肿瘤6例（7.7%）。 结论：青少年恶性实体肿瘤以中枢神经系统肿瘤最多见，神经母细胞瘤、横纹肌肉瘤和颅外恶性生殖细胞瘤预后不佳。

关键词: 青少年, 实体肿瘤, 预后, 多中心

Abstract: children and adults. Objective：To summarize the clinical characteristics and prognosis of adolescent malignant solid tumors in multiple centers in Beijing. Design：Cross-sectional survey. Methods：This retrospective study analyzed the clinical characteristics and prognosis of adolescents over the age of 120 months with the initial diagnosis of malignant solid tumors in seven hospitals in Beijing from January 1, 2010 to December 31, 2019. Main outcome measures：Three-year event free survival (EFS) and overall survival (OS). Results：A total of 411 patients were enrolled in this study with a median age of 150 months (120-216 months). In total, 239 patients(58.2%) were males and 172(41.8%) were females. There were 183 patients(44.5%) with central nervous system tumors, 82(20%) with Ewing sarcoma, 47(11.4%) with rhabdomyosarcoma, 33(8%) with neuroblastoma, 29(7.1%) with non-rhabdomyosarcoma soft tissue sarcomas, 18(4.4%) with extracranial germ cell tumors and 19(4.6%) with other rare tumors. Among the 411 patients, the top three regions of registered residence were North China(160 cases, 38.9%), East China(97 cases, 23.6%) , South Central China(70 cases, 17%). There were 129 patients(31.4%) treated at one hospital, 180 patients(43.8%) at two hospitals, and 102 patients (24.8%) at three or more hospitals. The median follow-up time of 411 patients was 26 months(1-120 months). At the end of follow-up, 333 patients (81.0%) survived, 78 patients(19%) died, and 145 patients(35.3%) had tumor relapse or progression. The 3-year EFS rate was 60.3%, and the 3-year OS rate was 79.5%. The median survival time of 78 cases of death was 13 months(1-65 months), including 22 patients(28.2%) with central nervous system tumors, 18(23.1%) with rhabdomyosarcoma, 16(20.5%) with Ewing sarcoma, 8(10.3%) with neuroblastoma, 3(3.8%) with extracranial malignant germ cell tumors, 5(6.4%) with non-rhabdomyomatous soft tissue sarcomas and 6(7.7%) with rare tumors. Conclusion：Center nervous system tumors are the most common malignant solid tumors in adolescents. The prognosis of neuroblastoma, rhabdomyosarcoma and extracranial malignant germ cell tumor in adolescents is poor.

Key words: Adolescents, Solid tumors, Prognosis, Multicenter