Liang Wei-Ling, Ye Xiao-Fan, Zhong Gong, Chen Jian-Jun, Dai Kang-Lin, Cheuk Ka Leung Daniel, Mo Shu, Wang Bo-Shen, Li Chun-Yu, Jiang Xuan-Zhu, Xu Zhi-Yuan, Zhou Li, Chan Irene, Chen Jian-Liang, Chu Patrick, Lee Pui Wah Pamela, Chan Chi Fung Godfrey
Department of Pediatrics, Hong Kong University-Shenzhen Hospital, Shenzhen, Guangdong 518000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Jul 15;24(7):759-764. doi: 10.7499/j.issn.1008-8830.2203049.
To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma.
A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021.
The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had - gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years.
Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.
研究4期神经母细胞瘤联合治疗的早期临床疗效。
对2016年1月至2021年6月在香港大学深圳医院确诊的14例4期神经母细胞瘤患儿的医疗数据和随访数据进行回顾性分析。
这14例患儿的中位发病年龄为3岁7.5个月。其中，9例骨髓活检结果为阳性，4例有 - 基因扩增，13例神经元特异性烯醇化酶升高，7例尿香草扁桃酸升高。根据病理检查结果，6例患儿为分化型，1例为未分化型，1例为混合型，6例为低分化型。所有患儿中，10例接受N7方案化疗（其中2例加用三氧化二砷），4例接受Rapid COJEC方案化疗。13例患儿接受了手术，14例接受了造血干细胞移植，10例接受了放疗。共有8例患儿接受了Ch14.18/CHO免疫治疗，其中1例在免疫治疗期间因过敏性休克停药，其他7例完成Ch14.18/CHO治疗且无严重不良事件，其中1例复发后接受了3次Lu177 Dotatate治疗，目前仍在接受化疗。14例患儿的中位随访时间为45个月。4例患儿在2年内复发，2年总生存率为100%；4例患儿在3年内复发，7例患儿在3年内无病生存。
推荐对4期神经母细胞瘤患儿采用多学科联合治疗，有助于其获得更好的生存和预后。
