Alpuim Costa Diogo, Gonçalves-Nobre J Guilherme, Sampaio-Alves Mafalda, Guerra Nuno, Arana Ribeiro Joana, Espiney Amaro Carla
Hematology and Oncology Department, CUF Oncologia, Lisbon, Portugal.
Centro de Medicina Subaquática e Hiperbárica (CMSH), Portuguese Navy, Lisbon, Portugal.
Front Oncol. 2023 Sep 26;13:1254322. doi: 10.3389/fonc.2023.1254322. eCollection 2023.
Neuroblastoma is the most frequently diagnosed cancer during the first year of life. This neoplasm originates from neural crest cells derived from the sympathetic nervous system, adrenal medulla, or paraspinal ganglia. The clinical presentation can vary from an asymptomatic mass to symptoms resulting from local invasion and/or spread of distant disease spread. The natural history of neuroblastoma is highly variable, ranging from relatively indolent biological behavior to a high-risk clinical phenotype with a dismal prognosis. Age, stage, and biological features are important prognostic risk stratification and treatment assignment prognostic factors. The multimodal therapy approach includes myeloablative chemotherapy, radiotherapy, immunotherapy, and aggressive surgical resection. Hyperbaric oxygen therapy (HBOT) has been proposed as a complementary measure to overcome tumor hypoxia, which is considered one of the hallmarks of this cancer treatment resistance. This article aims to review the relevant literature on the neuroblastoma pathophysiology, clinical presentation, and different biological and genetic profiles, and to discuss its management, focusing on HBOT.
神经母细胞瘤是一岁以内最常被诊断出的癌症。这种肿瘤起源于源自交感神经系统、肾上腺髓质或椎旁神经节的神经嵴细胞。临床表现从无症状肿块到因局部侵犯和/或远处疾病扩散引起的症状不等。神经母细胞瘤的自然病程差异很大,从相对惰性的生物学行为到预后不佳的高危临床表型。年龄、分期和生物学特征是重要的预后风险分层和治疗分配预后因素。多模式治疗方法包括清髓性化疗、放疗、免疫疗法和积极的手术切除。高压氧治疗(HBOT)已被提议作为一种补充措施来克服肿瘤缺氧,肿瘤缺氧被认为是这种癌症治疗耐药的标志之一。本文旨在综述关于神经母细胞瘤病理生理学、临床表现以及不同生物学和基因特征的相关文献,并讨论其治疗,重点是高压氧治疗。