Clinical characteristics and prognosis of children aged five or above with stage 3/4 neuroblastoma

Abstract

Objective To study the clinical characteristics and prognosis of children aged 5 or above with stage 3/4 neuroblastoma (NB). Method Among 180 children with NB admitted from March 2007 to June 2015, 54 were aged 5 or above with stage 3 or 4. The clinical characteristics, therapeutic efficacy and prognosis of above 54 cases were analyzed. Results There were 36 boys and 18 girls with a male to female ratio of 2∶1. The most common of primary site was retroperitoneum (41/54, 75.5%), followed by mediastinum (10/54, 18.5%), spine and pelvic cavity (3/545, 6%). After treated by average 9 cycles of chemotherapy, 34 cases (63%) achieved complete remission (CR), 13(24.1%) achieved partial remission (PR), 5 (9.3%) presented disease progression (DP), and 2 died (3.7%). Patients were followed up for median 30 months (8-99 months), 24 cases died and 30 survived with a overall survival (OS) rate of 55.6%. In 30 survival cases, there were 23 cases (76.7%) of event-free survival (EFS) , and 6 cases (20.0%) of PR and 1 case (3.3%) of DP. There were significant differences in prognosis among patients with different responses to first therapy (χ2=8.963, P=0.003). Among 20 children with stage 4 NB treated by autologous peripheral blood stem cell transplantation (APBSCT), 13 cases died and 7 survived with an average survival time of(73.55±8.89)months. Among 29 cases without APBSCT, 11 cases died and 18 survived with an average survival time of(40.19±5.52)months. There was no significant difference in survival between APBSCT and no-APBSCT. Conclusion Children aged 5 or above with NB tend to have advanced stage, relapse and long treatment cycle, but the survival still can be improved with the appropriate treatment. Key words: Neuroblastoma; Child; Treatment outcome; Prognosis