NB09方案治疗4期神经母细胞瘤患儿效果分析  

Analysis of curative effect of the NB09 protocol based on 95 children with stage 4 neuroblastomas

作　　者：钟本富 赵强[1] 闫杰[1] 王景福[1] 李璋琳[1] 曹嫣娜[1] 李杰[1] 李忠元[1] 王会娟[1] 

机构地区：[1]天津医科大学肿瘤医院儿童肿瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,300060

出　　处：《天津医药》2016年第2期213-217,共5页Tianjin Medical Journal

基　　金：天津市应用基础研究计划项目(10JCYBJC11600)

摘　　要：目的探讨4期神经母细胞瘤（NB）患儿的综合治疗效果及预后。方法回顾性分析95例4期NB患儿，根据患儿接受的治疗方案，比较NB09方案及非NB09方案的疗效差别，并分析影响4期患儿预后的相关因素。全组患儿中位年龄48个月（4—136个月），中位随访时间21个月（4—179个月），NB09方案治疗患儿40例，非NB09方案治疗55例。结果NB09组患儿3年总生存率（OS）及无疾病进展生存率（PFS）情况均明显好于非NB09组（r分别为6．916和10．025，P〈0．05）。对全组患儿预后行单因素分析，治疗方案、病理类型、骨髓受累〉20％、N—MYC扩增、手术范围、是否维甲酸诱导、乳酸脱氢酶（LDH）〉1000U／L及短期疗效达非常好的部分缓解（VGPR）为影响全组患儿预后的因素。多因素分析显示，影响整组患儿预后的独立因素为骨髓受累〉20％（P〈0．05）。结论接受了NB09方案治疗的4期患儿预后较其他患儿好，骨髓受累〉20％的4期患儿预后差，需加强治疗强度。Objective To assess the outcomes of stage 4 neuroblastomas （NB）, and analyze the associated prognostic factors. Methods Ninety-five children with stage 4 NB were retrospectively analyzed. The curative effects and related factors affecting prognosis were compared between NB09 protocol group （n=40） and non-NB09 group （n=55）. The median age of 95 children was 48 months （4-136 months）, and the median follow-up time was 21 months （4-179 months）. Results The total survival rate and progression free survival rate were significantly better in NB09 group than those of non-NB09 group （~=6.916 and 0.025, P 〈 0.05）. The univariate analysis showed that treatment plan, pathologival type, bone marrow involve- ment〉20%, N-MYC amplification, surgical extent 〈 90%, non-therapy of cis-retinoic acid, LDH〉 1 000 U/L and very good partial remission （VGPR） were the influencing factors for the prognosis in children （P 〈 0.05）. Multivariate regression analysis showed that bone marrow involvement〉20% was the bad independent prognostic factors for stage 4 patients. Conclusion Children with stage 4 NB treated according to the NB09 protocol have a better prognosis. Children of stage 4 neuroblastomas with bone marrow involvement 〉20% have a bad prognosis to current treatment.

关 键 词：神经母细胞瘤 治疗 预后 JL童 NB09方案 

分 类 号：R739.4[医药卫生—肿瘤]