Feng Chen, Tang Suoqin, Wang Jianwen, Liu Ying, Yang Guang
Department of Pediatrics, General Hospital of PLA, Beijing 100853, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2013 Aug;33(8):1107-10.
To evaluate chemotherapy-related toxicity and the short-term efficacy of topotecan and cyclophosphamide as maintenance chemotherapy for stage IV neuroblastoma in complete remission.
The clinical data of 16 children with stage IV neuroblastoma received 3 cycles of maintenance chemotherapy with topotecan (0.75 mg·m(-2)·day(-1), infused on days 0-4) and cyclophosphamide 250 mg·m(-2)·day(-1), infused on days 0-4). The two-year event-free survival after complete remission was recorded and the chemotherapy-related toxicities were evaluated according to the Common Terminology Criteria for Adverse Events of the National Cancer Institute.
The most common chemotherapy-related toxicity was bone marrow suppression and suppressions of neutrophils, hemoglobin and platelets, which occurred in all the patients mostly of grade III and IV. All the patients experienced episodes of infections, which were controlled effectively with antibiotics. Impairment of gastrointestinal and liver functions in these cases was mostly mild (grade I and II) and recovered after corresponding treatments. None of the patients exhibited damages in the nervous system or the renal or cardiac functions. After complete remission, the two-year event-free survival rate of these patients was 68.75% (11/16).
Topotecan plus cyclophosphamide for maintenance chemotherapy can be effective and relative safe for stage IV neuroblastoma in complete remission, thus giving a chance to those patients who choose not to have stem cell transplantation.
评估拓扑替康和环磷酰胺作为IV期神经母细胞瘤完全缓解后维持化疗的化疗相关毒性及短期疗效。
16例IV期神经母细胞瘤患儿接受3个周期的维持化疗，拓扑替康（0.75mg·m⁻²·天⁻¹，第0 - 4天静脉输注）和环磷酰胺250mg·m⁻²·天⁻¹（第0 - 4天静脉输注）。记录完全缓解后的两年无事件生存率，并根据美国国立癌症研究所不良事件通用术语标准评估化疗相关毒性。
最常见的化疗相关毒性是骨髓抑制以及中性粒细胞、血红蛋白和血小板的抑制，所有患者均出现，大多为III级和IV级。所有患者均有感染发作，经抗生素有效控制。这些病例的胃肠道和肝功能损害大多为轻度（I级和II级），经相应治疗后恢复。无患者出现神经系统、肾脏或心脏功能损害。完全缓解后，这些患者的两年无事件生存率为68.75%（11/16）。
拓扑替康加环磷酰胺用于维持化疗对IV期完全缓解的神经母细胞瘤可能有效且相对安全，从而为那些选择不进行干细胞移植的患者提供了机会。
