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目的 探讨肾母细胞瘤的治疗模式及提高肾母细胞瘤的治疗效果。方法 对 1998～2 0 0 1年明确诊断的 2 0例肾母细胞瘤采用多学科协作模式进行治疗 ,即以NWTS 5治疗方案为蓝本由泌尿科、血液肿瘤科、放疗科、放射科、病理科等学科共同制定统一的治疗方案 ,通过分工协作按统一模式对Wilms’瘤根据分期、病理类型及其他危险因素进行分组并按不同分组实施相应综合治疗。治疗结果与 1995年 8月～ 1998年 5月传统治疗模式下的由泌尿科单学科负责治疗 (包括手术、化疗、放疗、肾动脉栓塞、LAK细胞治疗等 )的 16例Wilms’瘤比较 ,以了解不同治疗模式对Wilms’瘤疗效的影响。结果 本组Ⅰ期 5例 ;Ⅱ期 5例 ;Ⅲ期 6例 ;Ⅳ期 3例 ;Ⅴ期 1例。病例分型FH型 14例 ;UFH型 3例 ;透明细胞肉瘤 2例和恶性肾横纹肌样肉瘤 1例。初治停药复发病例 1例 (复发率 5 % ) ,再次治疗完全缓解 ;初治失败并死亡 2例 ,病死率 10 %。目前无瘤生存 18例 (90 .0 % ) ,均已停药。对照组 :复发并死亡 6例 ,分别于术后 2个月至 8年死亡 ,复发率及病死率为 37.5 0 %。目前无瘤生存10例 (6 2 .5 0 % )。结果经统计学处理 ,二组疗效差异有显著性意义 (P <0 .0 5 )。结论 多学科协作模式下Wilms’瘤的综合治疗较果比单一泌尿科负责治疗有效、安
Objective To investigate the treatment modalities of Wilms ’tumor and to improve the therapeutic effect of Wilms’ tumor. Methods 20 cases of nephroblastoma with definite diagnosis from 1998 to 2001 were treated with multidisciplinary collaborative mode. That is, based on the NWTS 5 treatment plan, urological, hematological and oncology department, radiotherapy department, radiology department, Science and other disciplines to develop a unified treatment plan, through the division of labor according to a unified model of Wilms’ tumor according to staging, pathological type and other risk factors are grouped according to different groups to implement the appropriate comprehensive treatment. The treatment outcome was compared with 16 Wilms’ tumors treated by a single department of urology (including surgery, chemotherapy, radiotherapy, renal artery embolism, LAK cell therapy, etc.) under the traditional treatment mode from August 1995 to May 1998. Understand the effect of different treatment modalities on Wilms’ tumor efficacy. Results 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. The cases were classified into FH type in 14 cases, UFH type in 3 cases, clear cell sarcoma in 2 cases and malignant renal rhabdomyosarcoma in 1 case. In the first untreated cases, 1 patient relapsed (the recurrence rate was 5%), and again the treatment was completely relieved. The initial treatment failed and died in 2 cases, the fatality rate was 10%. No tumor-free survival in 18 cases (90.0%), have been discontinued. Control group: 6 cases were relapsed and died, which were respectively died from 2 months to 8 years after operation. The recurrence rate and mortality rate were 37.5%. There are 10 cases without any tumor (62.5%). Results After statistical analysis, the difference between the two groups was significant (P <0.05). Conclusion The multi-disciplinary collaborative treatment of Wilms’ tumor is more effective than single urology