| Objective: To analyze the early outcomes of multidisciplinary singlecenter CCCG-HB-2016 program in the treatment of hepatoblastoma(HB),to evaluate the feasibility,safety and effectiveness of this regimen,so as to provide a basis for further optimization of HB treatment regimen.Methods: By prospectively analyzed the clinical data of 23 newly diagnosed HB children whom were admitted in the Department of Pediatric Hematology and Oncology at hunan provincial people's hospital from August 2016 to January 2019(All children were treated with CCCG-HB-2016 program),We summarized the general data,clinical characteristics,histopathology,imaging,AFP,and toxic reaction after the chemotherapy,and the survival situations,adverse reactions during treatment,hospitalization period and hospitalization expenses with SPSS22.0 software.Results:1.Among the 23 cases,abdominal mass and abdominal pain were the most common situation,they respectively accounting for 14 cases(60.87%)and 5 cases(21.74%).5 cases of low risk,11 cases of medium risk and 7 cases of high risk.The ratio of male and female was 1.3:1,There was no significant difference between risk stratification and gender(c2=1.248,P=0.657);The minimum age at diagnosis was 3 months,themaximum age at diagnosis was 8 years old,and the median age at diagnosis was 2 years old.There were 82.6% patients onset within 3 years of age.There was no significant difference between risk stratification and age of onset(c 2=3.717,P=0.156).There were 8 cases with low birth weight and 15 cases with normal weight,the difference between risk stratification and birth weight with no statistic meaning(c2=1.465,P=0.481).2.Among the 23 cases,most of the HB children had abnormall y increasing in AFP,the difference between risk stratification and A FP with no statistic meaning(F=3.087,P=0.068).3.Among the 23 cases had performed CT examination,The masses were mostly single lesions with exogenous growth and accompanied with mixed manifestations of pseudocapsule,hemorrhage,necrosis,cystic degeneration and calcification.The mass' s density was lower than liver tissue under the CT and there was no cirrhosis.4.The histopathological types of the 23 cases were mixed epithelialmesenchymal type(30.43%)and epithelial-type(69.57%).The positive expression of immunohistochemicalCD34 was 19 of 23 cases.4 cases were negative.5.Among the 23 cases,the difference between risk stratification and surgical resection of the liver segment with no statistic meaning(c 2=6.986,P=0.859).6.Among the 23 cases,the organ function damage was transient after chemotherapy,and the myelosuppression was manifested as two-line oligosity(granulocyte and erythroid),and the difference between risk stratification and myelosuppression with no statistic meaning(c 2=6.986,P=0.004).7.Among the 23 cases,there were followed up for 0~28 months,with an average follow-up of 17 months.The survival rate(OS)was100%,and the event-free survival rate(EFS)was 95.65%.8.Among the 23 cases,the risk stratification was positively correlated with hospitalization costs and hospitalization stay,with correlation coefficients(r=0.614,P=0.011)and(r=-0.529,P=0.035),Conclusions:1.HB occurs in infants,with the onset of painless abdominal mass,Bmode ultrasonography is the first choice for the detection of abdominal masses.there are multiple single lesions with exogenous growth accompanied by pseudocapsule,hemorrhage,necrosis,cystic degeneration and calcification,which are clearly separated from normal liver tissue under the CT.2.Serum AFP is significantly increased and has no statistic meaning with risk stratification.It is an important tumor marker for disease diagnosis,disease monitoring,prognosis judgment and treatment guidance.3.The multidisciplinary CCCG-HB-2016 regimen for the treatment of HB has less toxic and the side effects of postoperative chemotherapr was controllable,with good feasibility,safety and economy. |
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