当前的争议:Wilms肿瘤患者是否需要胸部计算机断层扫描?

M D Cohen
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引用次数: 0

摘要

目的:回顾国家肾母细胞瘤研究(NWTS)小组关于胸部计算机断层扫描(CT)和胸片检测肺转移肾母细胞瘤的报告。患者与方法:对32例CT检出肺结节,胸片阴性的患者进行分析。5例患者被排除在进一步分析之外。在其余27例患者中,18例为IV期,接受三种药物和肺部照射治疗;其他9例患者接受低强度治疗,不进行肺部照射。研究人员发现两组患者的总生存率无显著差异(分别为94%和88%)。在早期的一项研究中,11名胸片正常且胸部CT结果阳性的儿童中有4名(36%)被忽视了CT检查结果。这些数据与对照人群的复发率仅为20%相比较。结果:这些研究没有统计学上解决胸部CT对生存率影响的问题。结论:所有儿童都应该受益于最敏感的影像学检查,包括CT,以检测肿瘤的扩散。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current controversy: is computed tomography scan of the chest needed in patients with Wilms' tumor?

Purpose: Reports from the National Wilms' Tumor Study (NWTS) Group on the subject of chest computed tomography (CT) versus chest radiograph for the detection of lung metastases from Wilms tumor are reviewed.

Patients and methods: Thirty-two patients with lung nodules detected by CT, with negative chest radiographs, were identified. Five patients were excluded from further analysis. Of the remaining 27 patients, 18 were treated as stage IV, receiving therapy with three drugs and lung irradiation; the other nine were treated with less intensive therapy and no lung irradiation. The investigators found no significant difference between the overall survival between these two groups of patients (94% and 88%, respectively). In an earlier study, four of 11 children (36%) with normal chest radiographs and positive chest CT results were treated by ignoring the CT findings. These data compared with a relapse rate of only 20% in a control population.

Results: The studies do not statistically address the question of the impact of CT of the chest on survival.

Conclusions: All children should have the benefit of the most sensitive imaging available, including CT, to detect tumor spread.

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