ABSTRACT
Objective To retrospectively analyze the clinical efficacy,safety and influencing factors of radiotherapy in children with stage Ⅳ high-risk neuroblastoma (HR-NB).Methods A total of 120 children with HR-NB who were diagnosed and treated with local radiotherapy according to the BCH-HR-NB-2007 protocol in the Oncology Department of Beijing Children's Hospital from January 2014 to December 2017 were enrolled.Among them,56 children were male and 64 female with a median age of 43 months (9 -148 months).The treatment protocol consisted of 4 cycles of CAV chemotherapy,3 cycles of CVP chemotherapy,surgical resection after 4 cycles,autologous hematopoietic stem cell transplantation after 7 cycles,local radiotherapy at a dose of 15.0-30.6 Gy for 82 cases of primary tumors and 38 cases of primary and metastatic tumors,followed by 13 cis-retinoic acid as maintenance therapy.The entire treatment protocol endured for approximately 18 months.Results The median follow-up time was 21 months.The 3-year local control rate was 84.4％.Before radiotherapy,the 3-year event-free survival rate was 78.4％ in children without metastases,significantly higher compared with 30.4％ in the residual group (P=0.003).The 3-year event-free survival rate was 66.1％ in patients who underwent radiotherapy within 6 months after surgery,significantly higher than 50.6％ in their counterparts receiving radiotherapy at 6 months or more after surgery (P=0.018).Among the children with residual metastases before radiotherapy,the progression rate in children who did not receive radiotherapy was 66.6％,significantly higher compared with 20.0％ in those receiving radiotherapy (P=0.001).All patients had no radiation-related adverse reactions in the liver,kidney and heart,etc.The incidence rate of grade Ⅲ-Ⅳ myelosupression was 24.5％ at 1 week post-radiotherapy,and 8％ at 2 weeks after radiotherapy.Conclusions Radiotherapy yields definite clinical efficacy in the local control of children with stage Ⅳ HR-NB.Early radiotherapy after surgery and radiotherapy for the metastatic lesions can improve the clinical prognosis.No vital organ injuries are observed during the short-term follow-up.At 2 weeks after radiotherapy,the myelosupression is gradually restored.
ABSTRACT
PURPOSETo analyze the role of radiotherapy in the treatment of olfactory neuroblastoma. METHODS From 1974 to 1994. 11 patients with olfactory neuroblastoma were treated in Xinjiang Cancer Hospital. All patients were confirmed histologically. Six cases were stage B and 5, stage C. Five patients were treated with surgery and postoperative radiotherapy (4. stage B and 1, stage C), and 6. with radiotherapy alone. The tumor dose ranged from 45~68 Gy, 2. 0 Gy/Fx. Neck irradiation with total dose of 60~65 Gy was carried out for 3 patients with cervical lymph node metastases. RESULTS Three patients had local recurrences and 2 cases, distant metastases. The actuarial overall survivals at 3 and 5 year were 55% and 36%, respectively. Three and five year survivals were 33%and 17% for the patients treated with radiotherapy alone, and 80% and 60% for the patients treated with surgery and postoperative irradiation, respectively(P= 0. 2727). CONCLUSION For the patients with stage B and C olfactory neuroblastoma, combined modality of surgery and radiotherapy should be the treatment of choice.