单中心儿童头颈部恶性实体肿瘤临床特征及预后分析

doi:10.3969/j.issn.1006-7795.2025.03.020

首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (3): 545-552.doi: 10.3969/j.issn.1006-7795.2025.03.020

单中心儿童头颈部恶性实体肿瘤临床特征及预后分析

杨佩仪¹,段超¹,王生才²,金眉¹,张大伟¹,伏利兵³,于彤⁴,刘志凯⁵,马晓莉¹,倪鑫^2*#,苏雁^1*#

1. 国家儿童医学中心，首都医科大学附属北京儿童医院，儿童肿瘤中心，肿瘤内科，儿童肿瘤国家临床重点专科，首都医科大学基础－临床联合实验室/儿童肿瘤发病机制与创新药物研究实验室，儿科重大疾病研究教育部重点实验室，北京 100045;2.国家儿童医学中心，首都医科大学附属北京儿童医院耳鼻咽喉头颈外科，北京 100045;3.国家儿童医学中心，首都医科大学附属北京儿童医院病理科，北京 100045;4.国家儿童医学中心，首都医科大学附属北京儿童医院影像中心，北京 100045;5.中国医学科学院北京协和医院放疗科，北京，100730

收稿日期:2024-06-12 出版日期:2025-06-21 发布日期:2025-06-25
通讯作者: 倪鑫, 苏雁 E-mail:nixin@ bch. com. cn;suyanbch@ sina. com
基金资助:
国家自然科学基金项目（82293660/82293665），国家重点研发计划项目（2023YFC2706100/ 2023YFC2706101）。

Analysis of clinical features and prognosis in pediatric malignant solid tumors of head and neck in single-center

Yang Peiyi¹, Duan Chao¹, Wang Shengcai², Jin Mei¹, Zhang Dawei¹, Fu Libing³, Yu Tong⁴, Liu Zhikai⁵, Ma Xiaoli¹, Ni Xin^2*#, Su Yan^1*#

1.Medical Oncology Department, Pediatric Oncology Center; National Key Clinical Discipline of Pediatric Oncology；Laboratory for Clinical Medicine，Capital Medical University；Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045，China； 2. Department of Otolaryngology Head and Neck Surgery, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China; 3.Department of Pathology, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China; 4.Department of Imaging, Beijing Children’s Hospital, Capital Medical University, National Center of Children’s Health, Beijing 100045, China; 5.Department of Radiotherapy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 100730

Received:2024-06-12 Online:2025-06-21 Published:2025-06-25
Supported by:
This work was supported by National Natural Science Foundation of China (82293660/82293665), National Key R&D Program of China (2023YFC2706100/ 2023YFC2706101).

摘要/Abstract

摘要： 目的分析头颈部恶性实体肿瘤患儿的临床特征及预后。方法回顾性分析2007年1月至2021年12月首都医科大学附属北京儿童医院肿瘤内科收治的原发灶位于头颈部的恶性实体肿瘤患儿的临床资料，总结临床特征、预后及其影响因素。结果纳入234例头颈部恶性实体肿瘤患儿，男女比1∶0.7，年龄3个月~17岁6个月（中位月龄51个月）。173例（73.9%）以局部无痛性肿物就诊，其他症状包括入睡打鼾、面瘫等。横纹肌肉瘤（rhabdomyosarcoma, RMS）比例最高（145例，62.0%），其次为神经母细胞瘤（neuroblastoma, NB）（25例，10.7%）、尤文（样）肉瘤（19例，8.1%）等。共47例（20.1%）发生远处转移。患儿接受多学科联合诊治模式（multidisciplinary treatment，MDT）下的手术、化学药物治疗、放射治疗等治疗，3年和5年总生存期（overall survival，OS）分别为80.8%和75.8%，3年和5年无进展生存期（progression free survival，PFS）分别为64.0%和58.9%。肿瘤幸存者存在外观或面部运动功能异常（49例，41.2%）、牙齿发育问题或异常脱落（18例，15.1%）等可能与肿瘤或其治疗相关的远期并发症。结论儿童头颈部恶性实体肿瘤病理类型多样，RMS、NB较常见，局部无痛性肿物是最常见的症状。是否发生远处转移是影响头颈部恶性实体肿瘤预后的独立危险因素。在MDT模式下，本中心头颈部常见恶性实体肿瘤的预后总体较好。头颈部恶性肿瘤的治疗需在争取长期生存的前提下，将副作用与后遗症控制在尽量小的范围内。

关键词: 头颈部, 恶性实体肿瘤, 儿童, 临床特征, 预后

Abstract: Objective To summarize the clinical features and prognosis of children suffered from malignant solid tumors of head and neck. Methods The clinical data of children with primary malignant solid tumors located in the head and neck was retrospectively analyzed from January 2007 to December 2021 in the Department of Oncology, Beijing Children's Hospital, Capital Medical University, and the clinical features, prognostic factors were summarized. Results A total of 234 children with malignant solid tumors of head and neck were included, with a male to female ratio of 1∶0.7, aged from 3 months to 17 years and 6 months (median age 51 months). 173 cases (73.9%) were treated with local painless masses. Other symptoms included snoring and facial paralysis. The proportion of rhabdomyosarcoma (RMS) was the highest (145 cases, 62.0%), followed by neuroblastoma (NB) (25 cases, 10.7%), Ewing sarcoma (19 cases, 8.1%), etc. A total of 47 cases (20.1%) had distant metastasis. The patients received surgery, chemotherapy and radiotherapy under the mode of multidisciplinary treatment (MDT). The 3-year and 5-year overall survival(OS) were 80.8% and 75.8%, respectively, and the 3-year and 5-year progression free survival(PFS) were 64.0% and 58.9%, respectively. Tumor survivors had abnormal appearance or facial motor function (49 cases, 41.2%), developmental problems or abnormal tooth loss (18 cases, 15.1%), and other long-term complications that may be related to the tumor or treatment. Conclusion There are various pathologic types of pediatric head and neck malignant solid tumors, RMS and NB are the most common. Local painless mass was the most common complaint. Distant metastasis is an independent risk factor for the prognosis of head and neck malignant solid tumors. Under the MDT model, the prognosis of malignant solid tumors of the head and neck in our center was generally good. In the treatment of the tumors, the side effects and sequelae should be controlled as small as possible under the premise of long-term survival.

Key words: head and neck, malignant solid tumor, children, clinical features, prognosis

中图分类号:

R739.8，R739.6

杨佩仪, 段超, 王生才, 金眉, 张大伟, 伏利兵, 于彤, 刘志凯, 马晓莉, 倪鑫, 苏雁. 单中心儿童头颈部恶性实体肿瘤临床特征及预后分析[J]. 首都医科大学学报, 2025, 46(3): 545-552.

Yang Peiyi, Duan Chao, Wang Shengcai, Jin Mei, Zhang Dawei, Fu Libing, Yu Tong, Liu Zhikai, Ma Xiaoli, Ni Xin, Su Yan. Analysis of clinical features and prognosis in pediatric malignant solid tumors of head and neck in single-center[J]. Journal of Capital Medical University, 2025, 46(3): 545-552.

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单中心儿童头颈部恶性实体肿瘤临床特征及预后分析

Analysis of clinical features and prognosis in pediatric malignant solid tumors of head and neck in single-center

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