威尔姆斯肿瘤治疗的后期影响。

S Silvente Bernal, O Girón Vallejo, A Sánchez Sánchez, C Menacho Hernández, J Rodón Berrío, B A Parra Gelder
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引用次数: 0

摘要

导言Wilms'肿瘤(WT)是儿童时期最常见的肾脏肿瘤。治疗方法的进步提高了患者的生存率,但同时也带来了长期的不良影响:对 1977 年至 2023 年的一系列病例进行了描述性回顾研究。结果:50 名患者(25 名男孩-25 名女孩)接受了治疗:共纳入 50 名患者(25 名男孩-25 名女孩),确诊时平均年龄为 3.6 岁(3 个月-11 岁)。其中大部分患者(94%)按照欧洲儿科肿瘤标准制定的方案进行治疗,该方案的特点是使用新辅助化疗。一名患者采用了美国的治疗方案。最常用的药物是长春新碱和放线菌素D(78%)。只有12名患者(28%)接受了蒽环类药物治疗。单侧肾切除术是最常用的手术方法(84%)。肾功能紊乱最常见(46%)。然而,二次肿瘤(9%)和生殖系统疾病(男孩和女孩各占 8%)的发生对患者的生活质量影响更大。有报告称,与所接受的治疗相关的多种疾病--心脏疾病(23%)、内分泌疾病(26%)和肺部疾病(15%):结论:WT 治疗对健康有影响。充分而严格的手术、密切的随访、限制化疗剂量和放射线照射可最大限度地减少长期后遗症。
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Late effects of Wilms' tumor treatment.

Introduction: Wilms' tumor (WT) is the most frequent renal tumor in childhood. Therapeutic management progression has increased survival rates, and as a result, long-term adverse effects.

Materials and methods: A descriptive retrospective study of a case series from 1977 to 2023 was carried out. The characteristics of the treatments received and the adverse effects listed on medical records were analyzed via phone surveys.

Results: 50 patients (25 boys-25 girls) with a mean age of 3.6 years (3 months-11 years) at diagnosis were included. Most of them (94%) were treated according to the protocol established by the European standards of pediatric oncology, which are characterized by the use of neoadjuvant chemotherapy. In one patient, the American treatment scheme was followed. The most common drugs used were vincristine and actinomycin D (78%). Only 12 patients (28%) received anthracyclines. Unilateral nephrectomy was the most frequent surgical technique (84%). Renal disorders were the most common (46%). However, the occurrence of second neoplasias (9%) and reproductive disorders (8% between boys and girls) had a greater impact on patients' quality of life. Multiple - cardiac (23%), endocrine (26%), and pulmonary (15%) - disorders associated with the treatments received were reported.

Conclusions: WT treatment has an impact on health. Adequate and rigorous surgery, close follow-up, and limiting chemotherapy doses and radiation exposure can minimize long-term sequels.

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