Clinical efficacy of combined therapy in children with stage 4 neuroblastoma
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
Abstract Objective To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma. Methods 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. Results 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 N-Myc 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. Conclusions Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.
LIANG Wei-Ling,YE Xiao-Fan,ZHONG Gong et al. Clinical efficacy of combined therapy in children with stage 4 neuroblastoma[J]. CJCP, 2022, 24(7): 759-764.
LIANG Wei-Ling,YE Xiao-Fan,ZHONG Gong et al. Clinical efficacy of combined therapy in children with stage 4 neuroblastoma[J]. CJCP, 2022, 24(7): 759-764.
Zhang S, Zhang W, Jin M, et al. Biological features and clinical outcome in infant neuroblastoma: a multicenter experience in Beijing[J]. Eur J Pediatr, 2021, 180(7): 2055-2063. PMID: 33580827. DOI: 10.1007/s00431-021-03989-1.
Applebaum MA, Vaksman Z, Lee SM, et al. Neuroblastoma survivors are at increased risk for second malignancies: a report from the International Neuroblastoma Risk Group Project[J]. Eur J Cancer, 2017, 72: 177-185. PMID: 28033528. PMCID: PMC5258837. DOI: 10.1016/j.ejca.2016.11.022.
Berthold F , Rosswog C , Christiansen H, et al. Clinical and molecular characterization of patients with stage 4(M) neuroblastoma aged less than 18 months without MYCN amplification[J]. Pediatr Blood Cancer, 2021, 68(8): e29038. PMID: 33826231. DOI:10.1002/pbc.29038.
Brodeur GM, Pritchard J, Berthold F, et al. Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment[J]. J Clin Oncol, 1993, 11(8): 1466-1477. PMID: 8336186. DOI:10.1200/JCO.1993.11.8.1466.
Li F, Zhang W, Hu H, et al. Factors of recurrence after complete response in children with neuroblastoma: a 16-year retrospective study of 179 cases[J]. Cancer Manag Res, 2022, 14: 107-122. PMID: 35023974. PMCID: PMC8747547. DOI: 10.2147/CMAR.S343648.
Ohira M, Nakamura Y, Takimoto T, et al. Retrospective analysis of INRG clinical and genomic factors for 605 neuroblastomas in Japan: a report from the Japan Children's Cancer Group Neuroblastoma Committee (JCCG-JNBSG)[J]. Biomolecules, 2021, 12(1): 18. PMID: 35053166. PMCID: PMC8774029. DOI: 10.3390/biom12010018.
Georgantzi K, Sk?ldenberg EG, Stridsberg M, et al. Chromogranin A and neuron-specific enolase in neuroblastoma: correlation to stage and prognostic factors[J]. Pediatr Hematol Oncol, 2018, 35(2): 156-165. PMID: 29737901. DOI: 10.1080/08880018.2018.1464087.
Sokol E, Desai AV, Applebaum MA, et al. Age, diagnostic category, tumor grade, and mitosis-karyorrhexis index are independently prognostic in neuroblastoma: an INRG project[J]. J Clin Oncol, 2020, 38(17): 1906-1918. PMID: 32315273. PMCID: PMC7280049. DOI: 10.1200/JCO.19.03285.
Uehara S, Yoneda A, Oue T, et al. Role of surgery in delayed local treatment for INSS 4 neuroblastoma[J]. Pediatr Int, 2017, 59(9): 986-990. PMID: 28643949. DOI: 10.1111/ped.13349.
Casey DL, Pitter KL, Kushner BH, et al. Radiation therapy to sites of metastatic disease as part of consolidation in high-risk neuroblastoma: can long-term control be achieved?[J]. Int J Radiat Oncol Biol Phys, 2018, 100(5): 1204-1209. PMID: 29439882. PMCID: PMC5934297. DOI: 10.1016/j.ijrobp.2018.01.008.
Zhao ZS, Shao W, Liu JK. Autologous or allogeneic hematopoietic stem cells transplantation combined with high-dose chemotherapy for refractory neuroblastoma: a protocol for systematic review and meta-analysis[J]. Medicine (Baltimore), 2021, 100(49): e28096. PMID: 34889262. PMCID: PMC8663834. DOI: 10.1097/MD.0000000000028096.
Jazmati D, Butzer S, Hero B, et al. Long-term follow-up of children with neuroblastoma receiving radiotherapy to metastatic lesions within the German Neuroblastoma Trials NB97 and NB 2004[J]. Strahlenther Onkol, 2021, 197(8): 683-689. PMID: 33300099. PMCID: PMC8292260. DOI: 10.1007/s00066-020-01718-5.
Shaanxi Province Diagnosis and Treatment Center of Kawasaki Disease/Children's Hospital of Shaanxi ProvincialPeople's Hospital, Children's Hospital of Shanghai Jiao Tong University, Beijing Children's Hospital of Capital MedicalUniversity, Shengjing Hospital of China Medical University, Affiliated Hospital of Yan'an University, Expert Committeeof Advanced Training for Pediatrician, China Maternal and Children's Health Association, General Pediatric Group ofPediatrician Branch of Chinese Medical Doctor Association, Pediatric International Exchange and Cooperation Center,Shanghai Cooperation Organization Hospital Cooperation Alliance, Editorial Board of Chinese Journal ofContemporary Pediatrics. Pediatric expert consensus on the application of aspirin in Kawasaki disease[J]. CJCP, 2022, 24(6): 597-603.
