El-Sayed Mohamed I, Ali Amany M, Sayed Heba A, Zaky Eman M
Department of Radiation Oncology, South Egypt Cancer Institute (SECI), Assiut University, Assiut, Egypt.
Int Arch Med. 2010 Dec 24;3:37. doi: 10.1186/1755-7682-3-37.
We conducted a retrospective analysis to investigate treatment results and prognostic factors of pediatric neuroblastoma patients.
This retrospective study was carried out analyzing the medical records of patients with the pathological diagnosis of neuroblastoma seen at South Egypt Cancer Institute, Assiut University during the period from January 2001 and January 2010. After induction chemotherapy, response according to international neuoblastoma response criteria was assessed. Radiotherapy to patients with residual primary tumor was applied. Overall and event free survival (OAS and EFS) rates were estimated using Graphed prism program. The Log-rank test was used to examine differences in OAS and EFS rates. Cox-regression multivariate analysis was done to determine the independent prognostic factors affecting survival rates.
Fifty three cases were analyzed. The median follow-up duration was 32 months and ranged from 2 to 84 months. The 3-year OAS and EFS rates were 39.4% and 29.3% respectively. Poor prognostic factors included age >1 year of age, N-MYC amplification, and high risk group. The majority of patients (68%) presented in high risk group, where treatment outcome was poor, as only 21% of patients survived for 3 year.
Multivariate analysis confirmed only the association between survival and risk group. However, in univariate analysis, local radiation therapy resulted in significant survival improvement. Therefore, radiotherapy should be given to patients with residual tumor evident after induction chemotherapy and surgery. Future attempts to improve OAS in high risk group patients with aggressive chemotherapy and bone marrow transplantation should be considered.
我们进行了一项回顾性分析，以研究小儿神经母细胞瘤患者的治疗结果和预后因素。
这项回顾性研究分析了2001年1月至2010年1月期间在阿斯尤特大学南埃及癌症研究所确诊为神经母细胞瘤患者的病历。诱导化疗后，根据国际神经母细胞瘤反应标准评估反应情况。对残留原发性肿瘤患者进行放射治疗。使用GraphPad Prism软件估计总生存率和无事件生存率（OAS和EFS）。采用对数秩检验来检验OAS和EFS率的差异。进行Cox回归多因素分析以确定影响生存率的独立预后因素。
分析了53例病例。中位随访时间为32个月，范围为2至84个月。3年OAS和EFS率分别为39.4%和29.3%。不良预后因素包括年龄>1岁、N-MYC扩增和高危组。大多数患者（68%）属于高危组，其治疗结果较差，只有21%的患者存活3年。
多因素分析仅证实了生存率与风险组之间的关联。然而，在单因素分析中，局部放射治疗可显著提高生存率。因此，对于诱导化疗和手术后仍有明显残留肿瘤的患者应给予放射治疗。未来应考虑尝试采用积极的化疗和骨髓移植来提高高危组患者的OAS。
