目的　改善儿童肾母细胞瘤预后。方法　对 1998年 10月～ 2 0 0 1年 10月住院明确诊断为肾母细胞瘤及肾肉瘤的 2 0例病人采用外科手术、内科化疗、选择性放疗 ,病理科、影像学科协作诊断综合治疗 (即上海儿童医学中心WT 99方案 )。按方案中条件根据分期及其他危险因素进行分组 ,并按分组给予不同药物组合和强度的化疗。Ⅰ期及Ⅱ期病理分型预后良好型的不放疗 ,估计手术不能完全切除时给予 2个疗程术前化疗。结果　全组 2 0例 ,年龄 7个月至 12岁。病理分类预后良好型14例 ,预后不良型 3例 ;透明细胞肉瘤 2例 ,横纹肌肉瘤样 1例。临床结合病理分期为Ⅰ期 5例 ,Ⅱ期5例 ,Ⅲ期 6例 ,Ⅳ期 3例 ,Ⅴ期 1例。全组 2 0例中获完全缓解 18例 ( 90 % ) ,2例初治失败 ,缓解后复发1例。无病生存时间平均 2 7个月 17例 ( 11～ 45个月 ) ,占 85 % ,目前均已停药。结论　所采用多专业联合诊断治疗工作模式及上海儿童医学中心WT 99诊治方案对儿童肾母细胞瘤有效 Objective To improve the prognosis of children with nephroblastoma. Methods Twenty patients diagnosed as nephroblastoma and nephrosarcoma from October 1998 to October 2001 were treated with surgical treatment, internal medicine chemotherapy, selective radiotherapy, pathology and imaging department (Shanghai Children’s Medical Center WT 99 program). According to the conditions of the program according to stages and other risk factors are grouped and given by different combinations of drugs and intensity of chemotherapy. Ⅰ and Ⅱ pathological type prognosis good type of radiotherapy, it is estimated surgery can not be completely removed given 2 courses of preoperative chemotherapy. Results The whole group 20 cases, aged 7 months to 12 years old. Pathological classification of 14 cases of good prognosis, poor prognosis in 3 cases; 2 cases of clear cell sarcoma, rhabdomyosarcoma in 1 case. There were 5 cases in stage Ⅰ, 5 cases in stage Ⅱ, 6 cases in stage Ⅲ, 3 cases in stage Ⅳ and 1 case in stage Ⅴ. Among the 20 cases, 18 cases (90%) were completely relieved, 2 cases failed initial treatment, and 1 case relapsed after remission. Disease-free survival in an average of 27 months, 17 cases (11 to 45 months), accounting for 85%, have been discontinued. Conclusion The multimodality diagnosis and treatment work mode adopted and the Shanghai Children’s Medical Center WT 99 diagnosis and treatment scheme are effective for children’s nephroblastoma