Dữ liệu thực tiễn về u nguyên bào tủy ở trẻ em: Chúng ta có thể cải thiện kết quả không?

Zeitschrift für Kinderheilkunde - Tập 180 - Trang 127-136 - 2020
Paula Sedano1, Carmen González-San Segundo1, Lourdes De Ingunza1, Pedro Cuesta-Álvaro2, Marta Pérez-Somarriba3, Francisco Diaz-Gutiérrez1, Carmen Garrido Colino4, Alvaro Lassaletta3
1Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
2Computing Services, Research Support, Complutense University of Madrid, Madrid, Spain
3Department of Pediatric Oncology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
4Pediatric Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Tóm tắt

U nguyên bào tủy (MB) là một khối u phát triển ác tính từ phôi thai, đặc biệt xảy ra ở trẻ em, với tỷ lệ sống sót tổng thể (OS) sau 5 năm lên tới 70%. Mục tiêu của nghiên cứu này là phân tích các biến số liên quan đến việc điều trị trong một tập hợp hồi cứu và đánh giá tác động của các tham số chất lượng điều trị lên tỷ lệ sống sót. Từ năm 2000 đến 2018, 40 bệnh nhi mắc u nguyên bào tủy, được điều trị theo các quy trình quốc tế hiện hành, đã được phân tích hồi cứu. Các chỉ số chất lượng điều trị được phân tích bao gồm mức độ phẫu thuật, các tham số xạ trị (RT) và các biến số hóa trị, liên quan đến độ sai lệch về thời gian và cường độ liều. Với thời gian theo dõi trung vị là 74 tháng (phạm vi, 6–195), OS sau 5 năm là 74 ± 7%, 81 ± 8% cho nhóm bệnh nhân nguy cơ chuẩn, và 55 ± 16% cho bệnh nhân nguy cơ cao (p = 0.090). Tỷ lệ sống sót không có bệnh sau 5 năm không bị ảnh hưởng đáng kể bởi mức độ phẫu thuật (p = 0.428) và các biến số liên quan đến RT như khoảng thời gian giữa phẫu thuật và RT (p = 0.776), cũng như thời gian RT (p = 0.172) và sự tuân thủ hóa trị duy trì (p = 0.634). Phân tích đa biến đã xác định các nhóm nguy cơ dự đoán tỷ lệ sống sót không có bệnh kém hơn (p = 0.032) và sự lan tỏa màng nhện liên quan đến OS kém hơn (p = 0.029). Kết luận: Tối ưu hóa điều trị đã cải thiện tỷ lệ sống sót của bệnh nhân mắc MB. Tuy nhiên, trong nghiên cứu của chúng tôi, chúng tôi chưa thiết lập được ảnh hưởng rõ ràng của các tham số chất lượng điều trị xạ trị và hóa trị được xem xét đến các kết quả.

Từ khóa


Tài liệu tham khảo

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