Riaz Saima, Bashir Humayun, Khan Saadiya Javed, Qazi Abid
Shaukat Khanum Memorial Cancer Hospital and Research Centre, Clinic of Nuclear Medicine, Lahore, Pakistan
Shaukat Khanum Memorial Cancer Hospital and Research Centre, Clinic of Pediatric Oncology, Lahore, Pakistan
Mol Imaging Radionucl Ther. 2018 Oct 9;27(3):121-125. doi: 10.4274/mirt.52533.
I-131 mIBG scan semi-quantitative analysis with modified Curie and the International Society of Pediatric Oncology Europe Neuroblastoma (SIOPEN) scoring systems is helpful in the evaluation of disease extent and has prognostic impact in stage 4 neuroblastoma.
Retrospective, cross-sectional analysis of baseline I-131 mIBG scans in 21 patients with stage 4 or 4S neuroblastoma diagnosed between January 2007 and December 2015. All scans were assessed for Curie and SIOPEN scores. Distribution of scores was evaluated for risk factors i.e. age at diagnosis (>18 months) and early relapse (within 12 months). A curie score <2 and SIOPEN score <4 at diagnosis were correlated with event-free survival (EFS) and overall survival (OS).
The data set comprised of 12 (57%) males and 9 (43%) females. Patients with age >18 months (n=9) at diagnosis or early relapse (n=9) had higher Curie [mean 5+7.5 standard deviation (SD), p=0.004] and SIOPEN (mean 5.2+10.8 SD, p=0.02) scores. Patients with a Curie score <2 and a SIOPEN score of <4 had better EFS and OS than patients with higher scores. Curie: 5-year EFS=Curie <2 (79%) versus Curie >2 (33%) (p=0.03); 5-year OS=Curie <2 (56%) versus Curie >2 (36%) (p=0.01). SIOPEN: 5-year EFS=SIOPEN <4 (70%) versus SIOPEN >4 (17%) (p=0.002); 5-year OS=SIOPEN <4 (58%) versus SIOPEN >4 (17%) (p=0.04). There was no statistically significant difference between the two scoring systems in terms of survival predictive value (Hazard ratio 2.38, 95% CI: 0.33-16.9, p=0.38).
I-131 mIBG Curie and SIOPEN scores have prognostication value in stage 4 neuroblastoma and should be routinely applied. Higher scores predict unfavorable prognosis.
采用改良居里评分系统和欧洲儿科肿瘤学会神经母细胞瘤国际（SIOPEN）评分系统对I-131间碘苄胍（mIBG）扫描进行半定量分析，有助于评估疾病范围，并对4期神经母细胞瘤的预后产生影响。
对2007年1月至2015年12月期间诊断为4期或4S期神经母细胞瘤的21例患者的基线I-131 mIBG扫描进行回顾性横断面分析。所有扫描均评估居里评分和SIOPEN评分。评估评分分布与危险因素的关系，即诊断时年龄（>18个月）和早期复发（12个月内）。诊断时居里评分<2和SIOPEN评分<4与无事件生存期（EFS）和总生存期（OS）相关。
数据集包括12例（57%）男性和9例（43%）女性。诊断时年龄>18个月（n=9）或早期复发（n=9）的患者居里评分[平均5+7.5标准差（SD），p=0.004]和SIOPEN评分[平均5.2+10.8 SD，p=0.02]更高。居里评分<2且SIOPEN评分<4的患者比评分更高的患者具有更好的EFS和OS。居里评分：5年EFS=居里评分<2（79%）对比居里评分>2（33%）（p=0.03）；5年OS=居里评分<2（56%）对比居里评分>2（36%）（p=0.01）。SIOPEN评分：5年EFS=SIOPEN评分<4（70%）对比SIOPEN评分>4（17%）（p=0.002）；5年OS=SIOPEN评分<4（58%）对比SIOPEN评分>4（17%）（p=0.04）。在生存预测价值方面，两种评分系统之间无统计学显著差异（风险比2.38，95%置信区间：0.33-16.9，p=0.38）。
I-131 mIBG居里评分和SIOPEN评分在4期神经母细胞瘤中具有预后价值，应常规应用。评分越高，预后越差。
