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目的 :评估NB09化疗方案在极高危成神经细胞瘤(neuroblastoma,NB)患儿中的疗效。方法 :回顾性分析2001年4月—2014年4月在天津医科大学肿瘤医院接受NB09方案或高危A/B方案治疗的63例极高危NB患儿的临床和随访资料,通过比较两种方案治疗患儿的手术切除情况、短期治疗结果、复发及生存情况,评估NB09方案的疗效。结果 :NB09组33例,高危A/B组30例。两组患儿在性别、年龄、病理类型、原发部位、转移部位、是否接受放疗等方面差异均无统计学意义(P值均>0.05)。治疗结束时,NB09组和高危A/B组患儿的完全缓解和非常好的部分缓解率(75.8%vs 73.3%)以及有效手术切除率(81.8%vs 90.0%)差异均无统计学意义(P值均>0.05)。Kaplan-Meier生存分析及log-rank检验结果显示,NB09组患儿的总生存及无事件生存情况均明显优于高危A/B组(P值均<0.05);而且NB09组患儿的2年内复发率较高危A/B组明显降低,差异具有统计学意义(P<0.05)。结论 :NB09方案可降低极高危NB患儿的复发率,延长患儿生存时间,具有积极的临床疗效。
OBJECTIVE: To evaluate the efficacy of NB09 chemotherapy in children with very-high-risk neuroblastoma (NB). Methods: The clinical and follow-up data of 63 children with very high risk NB who underwent NB09 regimen or high-risk A / B regimen from April 2001 to April 2014 in Cancer Hospital of Tianjin Medical University were retrospectively analyzed. By comparing the two regimens Surgical resection in children, short-term treatment results, recurrence and survival, assessment of the efficacy of NB09 program. Results: There were 33 cases in NB09 group and 30 cases in high risk A / B group. There was no significant difference between the two groups in terms of sex, age, pathological type, primary site, metastatic site, radiotherapy or not (P> 0.05). At the end of treatment, complete remission and very good partial remission rates (75.8% vs 73.3%) and effective surgeries (81.8% vs 90.0%) were not statistically different between NB09 and high-risk A / B groups ( P value> 0.05). Kaplan-Meier survival analysis and log-rank test showed that the overall survival and event-free survival of NB09 patients were significantly better than those of high-risk A / B patients (all P <0.05); and NB09 patients within 2 years The recurrence rate of high risk A / B group was significantly lower, the difference was statistically significant (P <0.05). Conclusion: NB09 regimen can reduce the recurrence rate of children with very high risk of NB, extend the survival time of children, with a positive clinical effect.