Jacobson G M, Sause W T, O'Brien R T
Am J Clin Oncol. 1984 Dec;7(6):693-7. doi: 10.1097/00000421-198412000-00018.
Children with neuroblastoma treated in Salt Lake City from 1966 through 1982 were analyzed in an attempt to develop guidelines for external beam radiation. Particular attention was addressed to time-dose relationships in those patients with residual disease post-resection (Stages II and III). Altogether, 76 patients were analyzed and survival rates were: Stage I--100%; Stage II--84%; Stage III--69.2%; Stage IV--14.3%; Stage IV-S--71.4%. Survival rates were correspondingly better in younger children and in infants. Indications for postoperative radiation therapy in this population were: unresectable or gross remaining tumor; residual tumor in neural foramina; tumor spill during surgery; positive regional lymph nodes or positive surgical margins. Local control was achieved in a majority of patients undergoing surgery and radiation for limited disease. In children younger than 1 year of age, no local failures were observed at doses above 1200 rad. In children between 1-2 years of age, no local failures were observed with doses as low as 1440 rad. In children older than 3 years, local failures were observed up to 4500 rad.
对1966年至1982年在盐湖城接受治疗的神经母细胞瘤患儿进行了分析，试图制定外照射放疗的指导原则。特别关注了那些术后有残留疾病（Ⅱ期和Ⅲ期）患者的时间-剂量关系。总共分析了76例患者，生存率分别为：Ⅰ期——100%；Ⅱ期——84%；Ⅲ期——69.2%；Ⅳ期——14.3%；Ⅳ-S期——71.4%。年幼儿童和婴儿的生存率相应更高。该人群术后放疗的指征为：无法切除或肉眼残留肿瘤；神经孔内残留肿瘤；手术中肿瘤溢出；区域淋巴结阳性或手术切缘阳性。对于大多数因疾病局限而接受手术和放疗的患者，实现了局部控制。在1岁以下儿童中，剂量高于1200拉德时未观察到局部失败。在1至2岁儿童中，剂量低至1440拉德时未观察到局部失败。在3岁以上儿童中，剂量高达4500拉德时观察到局部失败。
