Suc A, Lumbroso J, Rubie H, Hattchouel J M, Boneu A, Rodary C, Robert A, Hartmann O
Unit of Pediatric Oncology and Hematology, C.H.U. Purpan, Toulouse, France.
Cancer. 1996 Feb 15;77(4):805-11. doi: 10.1002/(sici)1097-0142(19960215)77:4<805::aid-cncr29>3.0.co;2-3.
Metaiodobenzylguanidine (mIBG) is a guanethidine analog that has demonstrated a high sensitivity and specificity in detecting bone metastases in about 90% of metastatic neuroblastomas. However, the predictive value of initial mIBG scan in neuroblastoma patients older than 1 year of age regarding response to initial chemotherapy has yet to be ascertained. Therefore, a scoring system for grading the positivity of mIBG scans was devised and applied in a retrospective study in an attempt to determine whether this score had a prognostic value in neuroblastoma patients older than 1 year of age at diagnosis.
Eighty-six children, older than 1 year of age, with metastatic neuroblastomas were homogeneously treated and had a mIBG scan performed at diagnosis and following the induction regimen to assess bone metastases. Each mIBG scan was assigned a reproducible score and the predictive value of the initial mIBG score was assessed in order to evaluate response to induction regimen.
The relative risk of failing to achieve complete remission after four courses of induction therapy was 6.9 times higher in patients who had more than four mIBG spots at diagnosis. A multivariate analysis including the established prognostic factors revealed that the initial mIBG score was the only significant factor (P < 0.001).
The initial mIBG scan is of prognostic significance to predict response to chemotherapy for metastatic neuroblastoma in children older than 1 year of age. A prospective study comparing this initial mIBG score with other recently established prognostic factors is warranted.
间碘苄胍（mIBG）是一种胍乙啶类似物，在检测约90%的转移性神经母细胞瘤的骨转移方面显示出高敏感性和特异性。然而，1岁以上神经母细胞瘤患者初始mIBG扫描对初始化疗反应的预测价值尚未确定。因此，设计了一种用于对mIBG扫描阳性进行分级的评分系统，并将其应用于一项回顾性研究中，以试图确定该评分在诊断时年龄大于1岁的神经母细胞瘤患者中是否具有预后价值。
86名年龄大于1岁的转移性神经母细胞瘤患儿接受了统一治疗，并在诊断时和诱导治疗方案后进行了mIBG扫描以评估骨转移情况。每次mIBG扫描都被赋予一个可重复的分数，并评估初始mIBG分数的预测价值，以评估对诱导治疗方案的反应。
诊断时mIBG斑点超过4个的患者在四个疗程诱导治疗后未达到完全缓解的相对风险高6.9倍。一项包括已确定的预后因素的多变量分析显示，初始mIBG分数是唯一的显著因素（P < 0.001）。
初始mIBG扫描对于预测1岁以上儿童转移性神经母细胞瘤对化疗的反应具有预后意义。有必要进行一项前瞻性研究，将这个初始mIBG分数与其他最近确定的预后因素进行比较。
