Hyperthermic Intraperitoneal Chemotherapy for Recurrent Nephroblastoma in Children.

CONCLUSION: For children with recurrent nephroblastoma, intraoperative HIPEC has little impact on the body, can significantly improve the effectiveness and reduce the recurrence rate, and does not increase the adverse reactions. KEY WORDS: Children, Recurrence, Nephroblastoma, Hyperthermic perfusion. METHODOLOGY: Sixty children with recurrent nephroblastoma treated by HIPEC in the Department of Surgical Oncology were analysed and divided into group A and group B, according to different perfused drugs. Additionally, 30 children without a history of HIPEC were selected as the control group (group C). The changes in routine blood indices, albumin, and hepatic and renal function of the three groups were observed before and after treatment. The clinical efficacy, frequency of adverse reactions, as well as 6-month and 1-year tumour recurrence in the three groups were compared. OBJECTIVE: To investigate the clinical efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of recurrent nephroblastoma in children. PLACE AND DURATION OF STUDY: Department of Oncology, Baoding Children's Hospital, from August 2018 to November 2021. RESULTS: The efficacy in groups A and B was significantly higher than that in group C (p<0.05). Changes in routine blood indices, albumin, and hepatic and renal function showed no statistically significant differences among the three groups during each observation period after treatment (all p>0.05). No significant differences were found in the incidence of adverse reactions among the three groups during treatment (all p>0.05). Six months after treatment, the tumour recurrence rate presented no significant differences among the three groups. However, at 12-months after treatment, the recurrence rate in groups A and B was lower than that in group C (p<0.05). STUDY DESIGN: Randomised controlled trial.

Multidisciplinary effort in treating children with hepatoblastoma in China.

The purpose of this study is to report the first nationwide protocol (Wuhan Protocol) developed by Chinese Children's Cancer Group and the results of multidisciplinary effort in treating hepatoblastoma. In this study, we reported the final analysis, which includes 153 hepatoblastoma patients in 13 hospitals from January 2006 to December 2013. The 6-year overall survival and event-free survival rates were 83.3 ± 3.1% and 71.0 ± 3.7%, respectively, in this cohort. The univariate analysis revealed that female (P = 0.027), under 5 years of age (P = 0.039), complete surgical resection (P = 0.000), no metastases (P = 0.000), and delayed surgery following neoadjuvant chemotherapy (P = 0.000) had better prognosis. In multivariate analysis, male, 5 years of age or above, stage PRETEXT III or IV, and incomplete surgical resection were among the some adverse factors contributing to poor prognosis. The preliminary results from this study showed that patients who underwent treatment following Wuhan Protocol had similar OS and EFS rates compared to those in developed countries. However, the protocol remains to be further optimized in standardizing surgical resection (including liver transplantation), refining risk stratification and risk-based chemotherapy.

Refractory diarrhea: A paraneoplastic syndrome of neuroblastoma.

Neuroblastoma (NB) is the most common extracranial solid tumor in children. Diarrheal NB is quite rare and is not easy to diagnose in the early stage. Six cases of diarrheal NB in our hospital treated from 1996 to 2006 were retrospectively analyzed, including characteristics such as electrolyte imbalance, pathologic features, vasoactive intestinal peptide (VIP) immunohistochemical staining results, treatment, and prognosis. All patients were boys with 3-8 loose or watery stools each day and routine fecal tests were normal. Abdominal tumors were identified by B-ultrasound. Drugs were ineffective. Three patients underwent surgery, and the remaining three patients received surgery and chemotherapy. Diarrhea stopped after treatment in five patients. Two patients died due to intractable hypokalemia. The tumor was located in the adrenal gland in four patients, in the upper retroperitoneum in one patient, and in the presacral area in one patient. Pathologic findings were NB and ganglioneuroblastoma. Five patients were at clinical stage I-II, and one was at stage III. Four patients survived (followed-up for 6 mo to 4 years). Immunohistochemical staining for VIP was positive. Refractory diarrhea is a paraneoplastic syndrome of NB and is rare. Patients aged 1-3 years who present with chronic intractable diarrhea should be followed closely. Intractable diarrhea, hypokalemia, and dysplasia are the initial clinical manifestations. Increased VIP is characteristic of this disease. Potassium supplementation plays a vital role in the treatment procedure, especially preoperatively. The prognosis of diarrheal NB is good following appropriate treatment.

Effect of Chinese drugs combining with chemotherapy on quality of life in 146 children with solid tumor.

OBJECTIVE: To explore the effect of Chinese drugs for supporting essence and strengthening Pi ( SESP) combining with chemotherapy on the quality of life (QOL) in the children with solid tumor. METHODS: Using a digital table, 146 children with solid tumor were randomized into two groups, 77 in the control group and 69 in the treated group. They received conventional chemotherapy, but to the patients in the treated group, SESP were administered additionally. The patients' scores of QOL and adverse reaction occurred were compared. RESULTS: The states in the treated group were superior to those in the control group. Statistical analysis showed that in the first year, the two groups were different in terms of somatic function, systemic symptoms, and general status (P<0.05) and also in the occurrence of adverse reaction (P<0.01). In the second year, the difference was shown in aspects of somatic function and adverse reaction occurrence (P<0.05). CONCLUSION: Chinese drugs for SESP combining with chemotherapy could raise tumor patients' QOL by improving their somatic function and clinical symptoms.

[Effect of supporting the healthy energy and strengthening Pi principle of TCM combined with chemotherapy in treating children with solid tumors].

OBJECTIVE: To study the clinical validity in improving quality of life (QOL) of patients and alleviating adverse reaction of chemotherapy in treating children with solid tumors by Chinese herbal medicine for supporting healthy energy and strengthening Pi. METHODS: A prospective cohort study was conducted in 60 children with solid tumor in stage II-IV, who were assigned to two groups, 30 in each group. All children received chemotherapy and those in the observed group were given Chinese herbs according to syndrome differentiation additionally. The conditions of the two groups were compared after 6-month treatment. RESULTS: Compared with before treatment, the white blood cells (WBC), hemoglobin (Hb), and platelet (PLT) all increased in the observed group after treatment (P < 0.01, P < 0.01, P < 0.05), while in the control group, the WBC and Hb have no significant difference (P > 0.05) and PLT decreased (P < 0.05) after treatment. Comparison between the two groups, the clinical symptom score in the observed group has significant difference after treatment (P < 0.05). CONCLUSION: Chinese herbal medicine for supporting healthy energy, strengthening Pi and supplementing qi-blood is good for alleviating the adverse reaction and improving patients' peripheral blood picture in children with solid tumor undergoing chemotherapy.