神经母细胞瘤:新辅助化疗疗效与影像学危险因子的相关性

Neuroblastoma:Correlation between the efficacy of neoadjuvant chemotherapy and image-defined risk factors

目的 观察新辅助化学治疗(简称化疗)用于神经母细胞瘤疗效与其影像学危险因子(IDRF)的相关性。方法 回顾性分析84例神经母细胞瘤患儿接受新辅助化疗前、后临床及CT资料,观察化疗后肿瘤原发灶体积缩小率及化疗前、后IDRF;将化疗效果分为非常好的部分缓解(VGPR)和非VGPR,分析原发灶体积缩小率与化疗后IDRF丢失量及残余量的相关性。结果 化疗前原发灶体积20.16~1 083.89 cm^(3)、中位体积331.33(154.82,513.46)cm^(3),IDRF数量1~10个、中位数为5(4,6)个;化疗后原发灶体积为0.26~511.82 cm^(3)、中位体积为33.96(11.75,83.35)cm^(3),IDRF数量为0~8个、中位数为3(2,4)个。化疗后原发灶体积缩小率17.00%~99.00%、中位数87.00%(72.00%,95.00%),33例VGPR、51例非VGPR;IDRF丢失量为0~8个、中位数为2(1,3)个,残余量为0~8个、中位数为3(2,4)个。化疗后原发灶体积缩小率与IDRF丢失量呈正相关(r=0.549,P<0.001),而与IDRF残余量呈负相关(r=-0.452,P<0.001)。结论 新辅助化疗用于神经母细胞瘤效果与化疗后病灶IDRF丢失量及残余量存在一定相关性。

Objective To investigate the correlation between the efficacy of neoadjuvant chemotherapy and image-defined risk factors(IDRF) of neuroblastoma. Methods Clinical and CT data of 84 children with pathologically confirmed neuroblastoma before and after neoadjuvant chemotherapy were retrospectively analyzed. The reduction rate of primary tumor volume and the presence of IDRF were observed. The efficacy of chemotherapy was evaluated according to the reduction rate of primary tumor volume, and the children were divided into very good partial response(VGPR) and non-VGPR. The correlation between the reduction rate of primary tumor volume and the number of lost and residual IDRF after chemotherapy were analyzed. Results The initial volume of primary tumor were 20.16—1 083.89 cm^(3), with a median of 331.33(154.82, 513.46) cm^(3), while the number of IDRF ranged from 1 to 10 at first visit, with a median of 5(4, 6), which became 0.26 cmto 511.82 cm^(3), with a median volume of 33.96(11.75, 83.35) cm^(3), and 0 to 8, with a median of 3(2, 4) after chemotherapy. The reduction rate of primary tumor volume ranged from 17.00% to 99.00%, with a median of 87.00%(72.00%, 95.00%). VGPR was obtained in 33 cases, non-VGPR in 51 cases. The number of lost IDRF ranged from 0 to 8, with a median of 2(1, 3), of residual IDRF ranged from 0 to 8, with a median of 3(2, 4). The reduction rate of primary tumor volume was positively correlated with the number of lost IDRF(r=0.549, P<0.001) but negatively correlated with the number of residual IDRF(r=-0.452, P<0.001). Conclusion The lost and remained number of IDRF had certain correlation with the efficacy of neoadjuvant chemotherapy for neuroblastoma.