Clinical characteristics and prognosis of children aged five or above with stage 3/4 neuroblastoma / 中华全科医师杂志

ABSTRACT

Objective To study the clinical characteristics and prognosis of children aged 5 or above with stage 3/4 neuroblastoma ( NB).Method Among 180 children with NB admitted from March 2007 to June 2015, 54 were aged 5 or above with stage 3 or 4.The clinical characteristics , therapeutic efficacy and prognosis of above 54 cases were analyzed.Results There were 36 boys and 18 girls with a male to female ratio of 2∶1.The most common of primary site was retroperitoneum (41/54, 75.5%), followed by mediastinum (10/54,18.5%), spine and pelvic cavity (3/545,6%).After treated by average 9 cycles of chemotherapy , 34 cases ( 63%) achieved complete remission ( CR ) , 13 ( 24.1%) achieved partial remission (PR), 5 (9.3%) presented disease progression (DP), and 2 died (3.7%).Patients were followed up for median 30 months ( 8 -99 months ) , 24 cases died and 30 survived with a overall survival (OS) rate of 55.6%.In 30 survival cases, there were 23 cases (76.7%) of event-free survival (EFS) ,and 6 cases (20.0%) of PR and 1 case (3.3%) of DP.There were significant differences in prognosis among patients with different responses to first therapy (χ2 =8.963, P =0.003 ).Among 20 children with stage 4 NB treated by autologous peripheral blood stem cell transplantation ( APBSCT ) , 13 cases died and 7 survived with an average survival time of (73.55 ±8.89)months.Among 29 cases without APBSCT, 11 cases died and 18 survived with an average survival time of(40.19 ±5.52)months.There was no significant difference in survival between APBSCT and no-APBSCT.Conclusion Children aged 5 or above with NB tend to have advanced stage , relapse and long treatment cycle , but the survival still can be improved with the appropriate treatment .