不同术前新辅助化疗方案应用于高危神经母细胞瘤的效果对比研究  

Comparative study on the efficacy of different preoperative neoadjuvant chemotherapy regimens in high-risk neuroblastoma

作　　者：田聪 席红卫[2] Tian Cong;Xi Hongwei(Department of Pediatric Medicine,Shanxi Medical University,Taiyuan 030001,China;Department of General Surgery,Shanxi Children′s Hospital,Taiyuan 030001,China)

机构地区：[1]山西医科大学儿科医学系,太原030001 [2]山西省儿童医院普外科,太原030001

出　　处：《中国医药》2024年第10期1471-1475,共5页China Medicine

基　　金：山西省重点研发计划(201903D321159)。

摘　　要：目的对比不同术前新辅助化疗方案应用于高危神经母细胞瘤(HR-NB)的效果。方法收集2016年1月至2019年1月于山西省儿童医院诊治的50例HR-NB患儿的临床资料进行回顾性分析。根据术前新辅助化疗方案的不同分为A组(30例)和B组(20例)。A组术前采用CAV(环磷酰胺+阿霉素+长春新碱)与CVP(环磷酰胺+依托泊苷+顺铂)方案交叉化疗;B组术前采用CAV(药物同A组)与VIP(依托泊苷+异环磷酰胺+顺铂)方案交叉化疗。对比2组化疗效果、手术完整切除率、不良反应及生存情况。结果B组化疗有效率明显高于A组[90.0%(18/20)比63.3%(19/30)],差异有统计学意义(P<0.05)。B组与A组手术完整切除率差异无统计学意义[85.0%(17/20)比63.3%(19/30)](P=0.148)。2组患儿耐受均良好,B组白细胞减少、血小板降低、呕吐腹泻及肝肾功能受损发生率均低于A组,差异均有统计学意义(均P<0.05)。Kaplan-Meier生存分析结果显示B组3年总体生存率高于A组,差异有统计学意义(67.2%比49.9%,Log-rankχ^(2)=3.986,P=0.046)。结论术前CAV与VIP交替化疗方案应用于HR-NB患儿可能效果较好,不良反应可耐受。Objective To compare the efficacy of different preoperative neoadjuvant chemotherapy regimens in high-risk neuroblastoma(HR-NB).Methods The clinical data of 50 children with HR-NB diagnosed and treated in Shanxi Children′s Hospital from January 2016 to January 2019 were collected and retrospectively analyzed.Patients were divided into group A(30 cases)and group B(20 cases)according to different preoperative neoadjuvant chemotherapy regimens.Group A was treated with CAV(cyclophosphamide+adriamycin+vincristine)and CVP(cyclophosphamide+etoposide+cisplatin)before surgery.Group B was treated with CAV(the same drug as group A)and VIP(etoposide+ifosfamide+cisplatin)chemotherapy before surgery.The chemotherapy effect,complete resection rate,adverse reactions and survival were compared between the two groups.Results The effective rate of chemotherapy in group B was significantly higher than that in group A[90.0%(18/20)vs 63.3%(19/30)](P<0.05).There was no significant difference in the complete resection rate between group B and group A[85.0%(17/20)vs 63.3%(19/30)](P=0.148).The children in both groups tolerated well.The incidences of leukopenia,thrombocytopenia,vomiting,diarrhea,and liver and kidney function damage in group B were lower than those in group A(all P<0.05).Kaplan-meier survival analysis showed that the 3-year overall survival rate in group B was higher than that in group A(67.2%vs 49.9%,Log-rankχ^(2)=3.986,P=0.046).Conclusions Preoperative CAV and VIP alternating chemotherapy regimen may be effective in children with HR-NB,and the adverse reactions can be tolerated.

关 键 词：高危神经母细胞瘤 新辅助化疗 手术切除 生存率 

分 类 号：R739.4[医药卫生—肿瘤]