Yoneda Akihiro, Nishikawa Masanori, Uehara Shuichiro, Oue Takaharu, Usui Noriaki, Inoue Masami, Fukuzawa Masahiro, Okuyama Hiroomi
Pediatric Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Osaka, Japan.
Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, 594-1101, Osaka, Japan.
Pediatr Surg Int. 2016 Mar;32(3):209-14. doi: 10.1007/s00383-016-3858-5. Epub 2016 Jan 13.
To date, no detailed study of the changes in the image-defined risk factors (IDRFs) after neoadjuvant chemotherapy has been performed. The aim of this study was to investigate the effect of chemotherapy on IDRFs for stage L2 neuroblastomas.
Fifteen stage L2 patients treated by neoadjuvant chemotherapy were selected. Changes after chemotherapy in the number of positive IDRFs, tumor size and major surgical complications were evaluated.
All IDRFs disappeared after chemotherapy in four patients (group A) and a reduction in the number of IDRFs, but not disappearance, after chemotherapy was observed in five patients (group B). No change in the number of IDRFs after chemotherapy was observed in six patients (group C). All tumors in groups A shrunk to <20 % of the pretreatment volume. Major surgical complications were observed in one of two, two of three and three of five patients who underwent tumor excision in groups A, B and C, respectively.
Only 27 % of the tumors with IDRFs became negative for IDRFs after chemotherapy. For negative IDRFs, tumors should shrink to <20 % of the volume at the time of diagnosis. Stage L2 tumors may have a potential risk for surgery even after neoadjuvant chemotherapy.
迄今为止，尚未对新辅助化疗后图像定义的风险因素（IDRFs）的变化进行详细研究。本研究的目的是探讨化疗对L2期神经母细胞瘤IDRFs的影响。
选择15例接受新辅助化疗的L2期患者。评估化疗后IDRFs阳性数量、肿瘤大小和主要手术并发症的变化。
4例患者（A组）化疗后所有IDRFs均消失，5例患者（B组）化疗后IDRFs数量减少但未消失，6例患者（C组）化疗后IDRFs数量无变化。A组所有肿瘤缩小至治疗前体积的<20%。A、B、C组分别有2例中的1例、3例中的2例和5例中的3例患者在接受肿瘤切除术后出现主要手术并发症。
化疗后，只有27%的有IDRFs的肿瘤IDRFs转为阴性。对于IDRFs阴性的情况，肿瘤应缩小至诊断时体积的<20%。即使经过新辅助化疗，L2期肿瘤仍可能存在手术潜在风险。
