Excellent treatment outcomes in children younger than 18 months with stage 4 MYCN nonamplified neuroblastoma / 소아과
Korean Journal of Pediatrics
;
: 53-58, 2018.
Article
in English
| WPRIM
| ID: wpr-741359
ABSTRACT
PURPOSE:
Although the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma.METHODS:
We retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens.RESULTS:
The most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17–91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ≥3 late adverse effects.CONCLUSION:
Patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Radiotherapy
/
Recurrence
/
Skin
/
Bone Marrow
/
Isotretinoin
/
Doxorubicin
/
Retrospective Studies
/
Follow-Up Studies
/
Carboplatin
Type of study:
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child
/
Humans
/
Infant
Language:
English
Journal:
Korean Journal of Pediatrics
Year:
2018
Type:
Article
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