100例神经母细胞瘤临床预后分析

  • 摘要: 目的:探讨神经母细胞瘤 (Neuroblastoma, NB) 的临床特征、 治疗方法及预后。方法:回顾性分析1995年4月至2009年8月天津医科大学附属肿瘤医院收治的并且随访资料完整的100例神经母细胞瘤患者的临床资料,比较不同因素对预后的影响。结果:中位随访期26.6个月(2~161个月);末次随访时CR 33例 (33%),中位CR时间为14.4个月;带瘤生存病情稳定20例,总生存率(SR)53%。全组1、2及5年总生存率分别为93.5%、81.5%及33.6%。单因素分析发现:肿瘤是否原发纵隔、INSSⅢ+Ⅳ期、NSE>100μg/L、LDH>700U/L、骨髓以外转移、手术方式、病理类型为影响预后的因素。多因素分析显示:纵隔以外原发、是否完全切除肿瘤及LDH>700U/L为独立的预后影响因素。结论: 原发于纵隔的神经母细胞瘤患者预后较其他部位好;神经母细胞瘤临床应采取手术、放疗及化疗为主的综合治疗, 手术完整切除肿瘤可明显改善其预后;检测血清LDH对评估NB患者预后具有重要的意义。

     

    Abstract: Clinical and Prognostic Analysis of 100 Patients with NeuroblastomaZhongyuan LI, Qiang ZHAO, JingfuWANG, Yanna CAO, Zhanglin LI, Jie YANCorrespondence to: Qiang ZHAO, E-mail: qiangzhao169@yahoo.com.cnDepartment of Pediatric Oncology, Tianjin Medical University Cancer Institute and Hospital,Key Laboratory of Cancer Preventionand Therapy, Tianjin 300060, ChinaAbstract Objective: To investigate the clinical features, treatment and prognostic factors of patients with neuroblastoma. Meth-ods: Clinical data of 100 patients with neuroblastoma with extensive follow-up, treated in our department between April 1995 and Au-gust 2009, were retrospectively analyzed and the prognostic factors were evaluated. Results: After a median follow-up of 26.6 months (ranged 2 to 161 months ), 33 cases had complete remission (CR) (median 14.4 months) and 20 cases had stable disease, with an overallsurvival rate ( SR ) of 53%. The 1-, 2-, and 5-year overall survival rates of the 100 patients were 93.5%, 81.5% and 33.6%, respectively.Univariate analysis revealed that the presence of tumor growing outside the mediastinum, INSS stage Ⅲ+Ⅳ, NSE > 100 μg/L, LDH >700 U/L, metastasis outside of the bone marrow, surgery and pathological type were prognostic factors. Multivariate analysis revealedthat the presence of tumor growing outside of the mediastinum, tumor resectability and LDH > 700 U/L were independent prognosticfactors. Conclusion: The prognosis for patients with neuroblastoma within the mediastinum is better than that for patients with neuro-blastoma elsewhere in the body. Patients with neuroblastoma should be treated with combined therapy that includes surgery, radiothera-py and chemotherapy. Complete resection of the tumor significantly improves the prognosis. Detecting serum LDH level contributes tothe determination of the prognosis for neuroblastoma patients.Keywords Neuroblastoma; Clinical characteristics; Combined modality therapy; Prognosis

     

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