NB09化疗方案在儿童极高危成神经细胞瘤中的疗效评估

Efficacy of NB09 regimen in chemotherapy for childhood ultra high-risk neuroblastoma

目的 :评估NB09化疗方案在极高危成神经细胞瘤(neuroblastoma,NB)患儿中的疗效。方法 :回顾性分析2001年4月—2014年4月在天津医科大学肿瘤医院接受NB09方案或高危A/B方案治疗的63例极高危NB患儿的临床和随访资料,通过比较两种方案治疗患儿的手术切除情况、短期治疗结果、复发及生存情况,评估NB09方案的疗效。结果 :NB09组33例,高危A/B组30例。两组患儿在性别、年龄、病理类型、原发部位、转移部位、是否接受放疗等方面差异均无统计学意义(P值均>0.05)。治疗结束时,NB09组和高危A/B组患儿的完全缓解和非常好的部分缓解率(75.8%vs 73.3%)以及有效手术切除率(81.8%vs 90.0%)差异均无统计学意义(P值均>0.05)。Kaplan-Meier生存分析及log-rank检验结果显示,NB09组患儿的总生存及无事件生存情况均明显优于高危A/B组(P值均<0.05);而且NB09组患儿的2年内复发率较高危A/B组明显降低,差异具有统计学意义(P<0.05)。结论 :NB09方案可降低极高危NB患儿的复发率,延长患儿生存时间,具有积极的临床疗效。

Objective： To evaluate the efficacy of NB09 regimen in chemotherapy for children with ultra high-risk neuroblastoma（NB）.Methods： The clinical and follow-up data of sixty-three children with ultra high-risk NB who had received chemotherapy with NB09 regimen or high-risk A/B regimen in Tianjin Medical University Cancer Institute and Hospital from April 2001 to April 2014 were retrospectively analyzed. The efficacy of NB09 regimen was accessed by comparing the surgical resection rate, short-term treatment outcomes, recurrence and survival between these two regimens.Results： Thirty-three patients were treated with NB09 regimen, and other 30 patients were treated with high-risk A/B regimen. There were no statistic differences in gender, age, pathology, primary lesion site, metastatic site, and treatment with radiotherapy between two groups（all P 0.05）. At the end of treatment, there were no significant differences in complete remission plus very good partial remission rate（75.8% vs 73.3%） and effective surgical resection rate（81.8% vs 90.0%） between two groups（both P 0.05）. Kaplan-Meier method and log-rank test showed that the overall survival and event-free survival of NB09 group were significantly better than those of the high-risk A/B group（both P 0.05）. The 2-year recurrence rate of NB09 group was significantly lower than that of the high-risk A/B group（P 0.05）.Conclusion： Chemotherapy with NB09 regimen can reduce the recurrence rate and prolong the survival time of children with high-risk NB, showing a positive clinical effect.