| |
著者: Tomoko Iehara, Akihiro Yoneda, Isao Yokota, Hideto Takahashi, Satoshi Teramukai, Takehiko Kamijyo, Atsuko Nakazawa, Tetsuya Takimoto, Atsushi Kikuta, Shigeki Yagyu, Hitoshi Ikeda, Akira Nakagawara, Tatsuro Tajiri, Japan Childhood Cancer Group Neuroblastoma Committee (JNBSG)
雑誌名: Pediatr Blood Cancer. 2019 Nov;66(11):e27914. doi: 10.1002/pbc.27914. Epub 2019 Jul 24.
Abstract/Text
BACKGROUND: The present study sought to reduce the incidence of treatment complications of low-risk neuroblastoma by using image-defined risk factors (IDRFs) to inform the timing of surgical resection.
PROCEDURES: Eligible patients included children (<18 years of age) with stage 1 or 2 disease, children (<365 days of age) with stage 3 disease, and infants with stage 4S disease. In IDRF-negative cases, treatment was completed with surgical resection alone. In IDRF-positive cases, the timing of surgery was determined based on the IDRFs after low-dose chemotherapy with 2-3 of the following four drugs: vincristine, cyclophosphamide, pirarubicin, and carboplatin. The outcome measures were overall survival, progression-free survival, and adverse events. This study was registered with the UMIN Clinical Trials Registry (number 000004355).
RESULTS: Of the 60 patients screened between 2010 and 2013, 58 eligible patients were enrolled; 32 were identified as IDRF negative at diagnosis while 26 were identified as IDRF positive and underwent induction chemotherapy. The 3-year overall and progression-free survival rates of the 58 patients were 100% and 82.8% (95% confidence interval: 70.3-90.3), respectively. Neutropenia was the most frequently reported grade 3 or 4 chemotherapy-related form of toxicity (41.7%). With regard to surgical complications, 2.5% of all patients developed pleural effusion and ascites as early complications, while only 2.5% developed renal atrophy as a long-term complication. No fatal toxicities were observed.
CONCLUSION: Using IDRFs to inform surgical decision making for the treatment of low-risk neuroblastoma improved prognosis and reduced the incidence of long-term complications.
© 2019 Wiley Periodicals, Inc.
PMID 31342649 Pediatr Blood Cancer. 2019 Nov;66(11):e27914. doi: 10.1002/pbc.27914. Epub 2019 Jul 24.
|
