儿科骨肉瘤的治疗方法
Leighton Elliott1, David M Loeb2, Matteo Trucco3
1Department of Medicine and Pediatrics, University of Florida College of Medicine, UF Health Cancer Center, Gainesville, FL.
Current opinion in pediatrics
|December 9, 2025
概括
患有转移性或复发性骨肉瘤的儿童的结局已经停滞不前. 结合氨酸激酶抑制剂与化疗的新策略和改进的风险分层显示出更好的儿科癌症治疗的希望.
科学领域:
- 儿科瘤学 儿科瘤学
- 骨系统新生体
- 癌症治疗方法 癌症治疗方法
背景情况:
- 局部的儿科骨肉瘤 (骨肉瘤和尤文肉瘤) 往往是可以治愈的,但转移或复发病例的结果仍然很差.
- 目前针对骨髓瘤和尤文瘤的前线治疗方法几十年来没有显著的进步.
- 像循环瘤DNA (ctDNA) 这样的新兴技术为改善诊断和风险分层提供了潜力.
研究的目的:
- 综合了近期诊断,风险分层,局部控制,全身疗法和儿科骨肉瘤生存率方面的临床相关进展.
- 审查有关儿童和青少年骨髓瘤和尤宁瘤治疗策略的进展.
- 以突出挑战和未来的方向在管理儿科骨癌.
主要方法:
- 关于儿科骨肉瘤近期临床发展和正在进行的研究的文献综述.
- 综合有关诊断工具,治疗方法和幸存者护理的数据.
- 分析新兴技术和临床试验结果.
主要成果:
- 骨髓瘤和尤文瘤的标准前线治疗方法没有改变.
- 循环瘤DNA (ctDNA) 显示出对验证和纳入治疗方案的承诺.
- 氨酸激酶抑制剂-化疗组合是目前改善前期治疗的策略,正在测试新型药物组合.
- 关于在骨髓瘤中进行肺转移切除的最佳手术方法的辩论仍在继续.
结论:
- 虽然单剂检查点抑制剂的疗效有限,但合理的氨酸激酶抑制剂-化疗组合,改善的生物风险分层 (ctDNA,MYC,STAG2) 和标准化的局部控制正在重塑护理.
- 短期的优先事项包括生物标志物定前期试验和支持性护理,以减少晚期影响.
- 临床试验对于获得对儿科骨瘤潜在改变范式的治疗策略至关重要.
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