70例儿童低中危神经母细胞瘤诊断和治疗的回顾分析

临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (5): 413-416.

70例儿童低中危神经母细胞瘤诊断和治疗的回顾分析

汤燕静，潘慈，薛惠良，陈静，董璐，周敏叶，启东，沈树红，王耀平，顾龙君，汤静燕

上海交通大学医学院附属上海儿童医学中心血液/肿瘤科（上海　200127）

收稿日期:2013-11-09 出版日期:2014-05-15 发布日期:2014-05-15

Outcome of children with low- or intermediate-risk neuroblastoma: a report of 70 cases

　Tang Yanjing, Pan Ci, Xue Huiliang, Chen Jing, Dong Lu, Zhou Min, Ye Qidong, Shen Shuhong, Wang Yao-ping, Gu Longjun, Tang Jingyan

(Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China)

Received:2013-11-09 Online:2014-05-15 Published:2014-05-15

摘要/Abstract

摘要：

　目的　总结分析低中危神经母细胞瘤（NB）患儿采用NB-99方案治疗的长期疗效及影响其预后的因素。方法　回顾性分析1999年1月至2008年10月初诊并接受NB-99方案治疗的70例低中危NB患儿的临床资料。结果　70例NB患儿中，低危组14例，中危组56例；获得完全缓解（CR）或非常好的部分缓解（VGPR）共67例（95.7%），部分缓解（PR）3例（4.3%）。10例复发，1例发生第二肿瘤，无化疗相关不良反应及化疗相关感染死亡病例。5年总生存率85.9%，无事件生存率81.0%。肿瘤骨髓转移、发病时年龄、分期、乳酸脱氢酶水平对预后有显著影响（P<0.05）。结论　完善遗传和分子生物学检测并改进治疗前的危险分层，对进一步改进治疗方案十分重要。

Abstract: 　Objectives　To evaluate the long-term outcomes of childhood low or intermediate risk neuroblastoma (NB) and their relevant prognostic factors. Methods　Total 70 new cases of low or intermediate risk NB diagnosed and treated by NB-99 protocol between 1999 and 2008 were analyzed retrospectively. Results　Of these 70 NB patients, fourteen patients were in low risk group and 56 were in intermediate risk group. 67 patients reached complete remission (CR) or very good partial remission (VGPR) and 3 (5%) achieved partial remission (PR). Ten patients relapsed. One patient occured second malignant neoplasm. No patients died of chemotherapy-related adverse events or infections the 5 year overall survival rate was 85.9%, event-free survival rate was 81.0%. Bone marrow infiltration, age at diagnosis, stage, lactate dehydrogenase level had a significant effect on prognosis. Conclusion　Develop cytogenetic and molecular biology tests and pretreatment risk stratification are important for further improve treatment protocol.

汤燕静，潘慈，薛惠良，陈静，董璐，周敏叶，启东，沈树红，王耀平，顾龙君，汤静燕. 70例儿童低中危神经母细胞瘤诊断和治疗的回顾分析[J]. 临床儿科杂志, 2014, 32(5): 413-416.

　Tang Yanjing,Pan Ci,Xue Huiliang,Chen Jing,Dong Lu,Zhou Min,Ye Qidong,Shen Shuhong,Wang Yao-ping,Gu Longjun,Tang Jingyan . Outcome of children with low- or intermediate-risk neuroblastoma: a report of 70 cases[J]. , 2014, 32(5): 413-416.

参考文献

[1] Maris JM，Hogarty MD，Bagatell R，et al. Neuroblastoma [J]. Lancet，2007，369(9579)：2106-2120.
[2] Ishola TA，Chung DH. Neuroblastoma. Surg Oncol [J]. 2007，16(3)：149-156.
[3] 汤静燕，潘慈，陈静，等. 45例儿童神经母细胞瘤预后因素分析 [J]. 中华儿科杂志，2006，44（10）：770-773.
[4] Brodeur GM，Seeger RC，Barrett A，et al. Revisions of the international criteria for neuroblastoma diagnosis，staging，and response to treatment [J]. J Clin Oncol，1993，11(8)：1466-1477.
[5] ?ra I，Eggert A. Progress in treatment and risk stratification of neuroblastoma：impact on future clinical and basic research [J]. Semin Cancer Biol，2011，21(4)：217-228.
[6] Cohn SL，Pearson AD，London WB，et al. The International Neuroblastoma Risk Group (INRG) classification system：an INRG Task Force report [J]. J Clin Oncol，2009，27(2)：289-297.
[7] 汤静燕，潘慈，刘茵，等. 儿童Ⅳ期神经母细胞瘤远期随访报告 [J]. 中国小儿血液与肿瘤杂志，2009，14(2)：66-70.
[8] 张广超，王景福. 国际神经母细胞瘤危险度分级（INRG）协作组最新共识 [J].中国肿瘤临床，2012，39(15)：1003-1007.
[9] Kushner BH，Cheung NK. Treatment reduction for neuroblastoma [J]. Pediatr Blood Cancer，2004，43(6)：619-621.
[10] Davidoff AM. Neuroblastoma [J]. Semin Pediatr Surg，2012，21(1)：2-14.
[11] Baker DL，Schmidt ML，Cohn SL，et al. Outcome after reduced chemotherapy for intermediate-risk neuroblastoma [J]. N Engl J Med，2010，363(14)：1313-1323.
[12] Strother DR，London WB，Schmidt ML，et al. Outcome after surgery alone or with restricted use of chemotherapy for patients with low-risk neuroblastoma：results of children’s oncology group study p9641 [J]. J Clin Oncol，2012，30(15)：1842-1848.