Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma
PurposeAlthough the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma.Method...
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| Format: | Article |
| Language: | English |
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Korean Pediatric Society
2018-02-01
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| Series: | Korean Journal of Pediatrics |
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| Online Access: | http://kjp.or.kr/upload/pdf/kjped-61-53.pdf |
| _version_ | 1819112892573679616 |
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| author | Chiwoo Kim Young Bae Choi Ji Won Lee Keon Hee Yoo Ki Woong Sung Hong Hoe Koo |
| author_facet | Chiwoo Kim Young Bae Choi Ji Won Lee Keon Hee Yoo Ki Woong Sung Hong Hoe Koo |
| author_sort | Chiwoo Kim |
| collection | DOAJ |
| description | PurposeAlthough the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma.MethodsWe retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens.ResultsThe most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17–91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ≥3 late adverse effects.ConclusionPatients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy. |
| first_indexed | 2024-12-22T04:20:44Z |
| format | Article |
| id | doaj.art-bc6b32945b234f9cb3a01602010bbe8a |
| institution | Directory Open Access Journal |
| issn | 1738-1061 2092-7258 |
| language | English |
| last_indexed | 2024-12-22T04:20:44Z |
| publishDate | 2018-02-01 |
| publisher | Korean Pediatric Society |
| record_format | Article |
| series | Korean Journal of Pediatrics |
| spelling | doaj.art-bc6b32945b234f9cb3a01602010bbe8a2022-12-21T18:39:17ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582018-02-01612535810.3345/kjp.2018.61.2.5320125550703Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastomaChiwoo Kim0Young Bae Choi1Ji Won Lee2Keon Hee Yoo3Ki Woong Sung4Hong Hoe Koo5Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.PurposeAlthough the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma.MethodsWe retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens.ResultsThe most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17–91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ≥3 late adverse effects.ConclusionPatients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy.http://kjp.or.kr/upload/pdf/kjped-61-53.pdfNeuroblastomaInfantNeoplasm metastasisN-myc proto-oncogene protein |
| spellingShingle | Chiwoo Kim Young Bae Choi Ji Won Lee Keon Hee Yoo Ki Woong Sung Hong Hoe Koo Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma Korean Journal of Pediatrics Neuroblastoma Infant Neoplasm metastasis N-myc proto-oncogene protein |
| title | Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma |
| title_full | Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma |
| title_fullStr | Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma |
| title_full_unstemmed | Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma |
| title_short | Excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma |
| title_sort | excellent treatment outcomes in children younger than 18 months with stage 4 nonamplified neuroblastoma |
| topic | Neuroblastoma Infant Neoplasm metastasis N-myc proto-oncogene protein |
| url | http://kjp.or.kr/upload/pdf/kjped-61-53.pdf |
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