Abstract:
Objective To discuss the interventional timing of radiotherapy stage Ⅳ high-risk neuroblastoma tumor around the great vessels.
Methods The tumor around the great vessels of 17 (11 males and 6 females) pediatric patients with high-risk neuroblastoma were identified from 2010 to 2011. Twelve patients underwent routine preoperative chemotherapy, operation, postoperative chemotherapy, and post-operative consolidation chemotherapy. Post-operative consolidation chemotherapy, which aims to eradicate the remaining tumor cells using cytotoxic agents at myeloablative doses, was followed by haematopoietic autologous stem cell rescue and local radiotherapy. Preoperative chemotherapy effect was not obvious in five cases which underwent preoperative radiotherapy.
Results Recurrence was observed on seven cases. Cerebral metastasis and bone metastasis were observed in 2 cases, local recurrence in 2 cases, and bone metastasis in 3 cases, which included 2 cases of extensive abdominal metastasis. The average time of recurrence was 2 months after radiotherapy. In 5 patients with preoperative radiotherapy in 4 cases with 3-4 week after radiotherapy can finish the operation, 1 Cases Systemic widely metastatic death.
Conclusion In the stages of preoperative chemotherapy, operation, postoperative chemotherapy, hematopoietic autologous stem cell transplantation, and strong chemotherapy involved in high risk neuroblastoma tumor around the great vessels, the site of primary tumor radiotherapy is necessary. This consideration is relevant despite poor prognosis and high recurrence because of the potential of radiotherapy to change the treatment path in hematopoietic stem cell transplantation of consolidation chemotherapy. Moreover, radiotherapy can improve local control rate and reduce transfer. Thus, radiotherapy is worthy of further clinical study. When preoperative chemotherapy is not sensitive to the use of preoperative radiotherapy, operation is an option.
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