天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (2): 189-192.doi: 10.11958/j.issn.0253-9896.2015.02.020

• 药物临床观察 • 上一篇    下一篇

NB09方案治疗高危和极高危神经母细胞瘤近期疗效观察

魏婵娟， 赵强△， 闫杰， 王景福， 李璋琳， 曹嫣娜， 李杰   

  1. 天津医科大学肿瘤医院儿童肿瘤科， 国家肿瘤临床医学研究中心， 天津市 “肿瘤防治” 重点实验室 （邮编300060）
  • 收稿日期:2014-04-15 修回日期:2014-10-05 出版日期:2015-02-15 发布日期:2015-02-27
  • 通讯作者: 赵强 E-mail:meihao666666@qq.com
  • 基金资助:
    天津市应用基础研究计划项目 （10JCYBJC11600）

Short term curative effect of NB09 protocol on high-risk and ultra-high-risk neuroblastoma

  • Received:2014-04-15 Revised:2014-10-05 Published:2015-02-15 Online:2015-02-27

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摘要： 摘要： 目的 评价中国儿童神经母细胞瘤协作组 09 方案(NB09 方案)治疗高危和极高危神经母细胞瘤的初步疗效。方法 回顾性分析 2009 年 1 月—2013 年 1 月天津医科大学肿瘤医院收治的高危和极高危神经母细胞瘤患儿的临床及随访资料。38 例患儿纳入分析， 其中男 27 例， 女 11 例。高危组 7 例， 极高危组 31 例。诊断时月龄 19～ 160 个月(中位就诊月龄 36.5 个月)。高危组： 术前新辅助化疗 A、 B 方案交替 4～6 周期后评估、 手术。极高危组手术前后化疗， 然后自体干细胞移植， 瘤床放疗， 停化疗后维甲酸治疗同高危组。结果 治疗结束时 CR 25 例， PR 5 例， SD 3 例， PD 5 例， 其中死亡 2 例， 治疗总有效率(CR+PR+SD) 86.8%。至随访结束， 全组无瘤生存 15 例， 带瘤生存 9 例， 死于肿瘤复发 7 例， 死于进展 7 例， 生存期 6～52 个月 (中位生存期 25.5 个月)， 其 1、 2、 3 年总生存率(OS)分别为 91.7%、 64.5%和 57.3%。Kaplan-Meier 生存曲线和 Log-rank 检验提示高危组与极高危组之间生存率差异无统计学意义(P=0.56)。结论 NB09 方案治疗高危和极高危神经母细胞瘤的近期疗效初步肯定， 值得进一步临床验证。

关键词: 神经母细胞瘤, 抗肿瘤联合化疗方案, 治疗结果, 儿童, 临床特点

Abstract: Abstract： Objective To evaluate the clinical outcome of NB09 (China Pediatric Neuroblastoma cooperative group 09) protocol on children with high-risk and ultra-high risk neuroblastoma. Methods The clinical and follow-up data of pa⁃ tients who suffered from high-risk (n=7) and ultra-high risk (n=31) neuroblastomas and admitted in Tumor hospital of Tian⁃ jin Medical University between January 2009 to January 2013 were retrospectively reviewed (27 boys and 11 girls). The age at diagnosis was 19-160 months (median age was 36.5 months). In the high risk group, patients were evaluated and operated after 4 to 6 circles of neoadjuvant chemotherapy. In ultra-high risk group, patient received chemotherapy before and after op⁃ eration, then autologous stem cell transplantation and tumor bed radiotherapy. After chemotherapy, retinoic acid treatment was given to patients in ultra high risk group as in high risk group. Results At the end of treatment, 25 patients achieved complete remission; 5 patients achieved partial remission; 3 patients were in stable disease; 5 patients were deteriorating in their conditions which lead to 2 deaths. In total, the response rate reaches upto 86.8%. By the end of follow up, 15 patients had a disease-free-survival, 9 patients survived with tumor, 7 died from recurrence and 7 died from deteriorating conditions. Survival time ranged from 6 to 52 months (median survival 25.5 months). The 1-, 2- and 3-year overall survival were 91.7%, 64.5% and 57.3% respectively. Kaplan-Meier curve and Log-rank test showed no statistical significance between high risk and ultra-high risk neuroblastomas. Conclusion The outcome of NB09 protocol for high risk and ultra-high risk neuroblastoma was preliminary affirmed. It is worthy of further clinical verification.

Key words: neuroblastoma;antineoplastic combined chemotherapy protocols, treatment outcome, child, clinical charac? teristics