Current Controversy: Is Computed Tomography Scan of the Chest Needed in Patients with Wilms' Tumor?
Current Controversy: Is Computed Tomography Scan of the Chest Needed in Patients with Wilms' Tumor?
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当前争议：肾母细胞瘤患者是否需要进行胸部计算机断层扫描？
DOI：
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
M. Cohen
中科院分区：
文献类型：
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作者：
M. Cohen
目的回顾美国国家肾母细胞瘤研究小组(NWTS)关于胸部计算机断层扫描(CT)与胸部X线片检查肺转移瘤的报告。病例与方法对32例胸部平片阴性、经CT检查发现的肺结节进行鉴别诊断。5名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，接受三种药物治疗并接受肺照射；另外9例接受较小强度治疗，不接受肺照射。研究人员发现，这两组患者的总体存活率没有显著差异(分别为94%和88%)。在早期的一项研究中，11名胸片正常、胸部CT结果阳性的儿童中有4名(36%)接受了忽略CT结果的治疗。这些数据与对照人群中只有20%的复发率形成对比。结果这些研究没有从统计学上解决胸部CT对生存的影响的问题。结论所有儿童都应该得到包括CT在内的最灵敏的成像，以检测肿瘤的扩散。
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.