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Clinical effectiveness of multimodality treatment on advanced pediatric hepatoblastoma
Y Zhang1, W-L Zhang, D-S Huang
1Department of Pediatrics, Chinese PLA General Hospital, Beijing, P.R. China. dongshenghuang99@163.com.
Insights
Multimodality treatment, including chemotherapy and surgery, significantly improves remission and survival rates in children with advanced hepatoblastoma. Prognosis is influenced by tumor type and stage.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Malignancies
- Cancer Therapeutics
Background:
- Hepatoblastoma is a rare but aggressive liver cancer in children.
- Advanced stages present significant treatment challenges and poor prognoses.
Purpose of the Study:
- To evaluate the efficacy of multimodality treatment for advanced hepatoblastoma.
- To identify prognostic factors influencing treatment outcomes in pediatric patients.
Main Methods:
- A cohort of 35 children with advanced hepatoblastoma received multimodality treatment.
- Treatment included chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation (APBSCT).
- Patients underwent monthly follow-up assessments.
Main Results:
- A 66.7% remission rate and 69.7% overall survival rate were observed in 33 patients.
- One patient with a large tumor achieved partial remission after high-dose chemotherapy and APBSCT.
- Mixed phenotype and Stage IV disease were associated with significantly worse prognoses (p < 0.001).
Conclusions:
- Multimodality therapy offers an effective strategy to enhance remission and survival in advanced hepatoblastoma.
- Alpha-fetoprotein (AFP) levels, pathological classification, and tumor staging are crucial for predicting patient outcomes.
Objectives:
To investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma and the factors affecting the prognosis.
Patients And Methods:
35 childhood patients were treated with multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. Patients were followed up every month.
Results:
33 patients completed the follow-up, of which 17 were in complete remission, 5 were in partial remission, 1 case got worse, and 10 died. The remission rate was 66.7% (22/33), and the overall survival rate was 69.7% (23/33). 1 patient with advanced hepatoblastoma got high-dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) treatment, and a primary lesion by 18 x 15 x 9 cm reduced to 10 x 8 x 4 cm. Remote metastases significantly alleviated, and partial remission reached six months. The overall survival was 9 months after transplantation. Patients with the mixed phenotype of hepatoblastoma had a worse prognosis than with the epithelial phenotype (p < 0.001), and patients in stage IV had a lower survival rate than in stage III (p < 0.001).
Conclusions:
Multimodality treatment can effectively improve remission rate and prolong the survival of children with the advanced hepatoblastoma. In addition, alpha-fetoprotein (AFP), hepatoblastoma pathological classification and staging are of great use in prediction of prognosis.
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