Comprehensive treatment and survival analysis of stage Ⅲ/Ⅳ neuroblastoma in children

Objective To summarize the clinical data about children with stage Ⅲ/Ⅳ neuroblastoma(NB)in a single center for 15 years,so as to provide suggestions for improving the treatment of advanced NB in children. Methods Seventy-six stage Ⅲ or ⅣNB children treated in our department from January 1,2001 to December 31,2015 were selected as the subjects.The clinical data and treatment regimen were retrospectively analyzed.Long-term survival was followed up and prognostic factors were explored. Results Of the 76 cases,36 cases were female(47.7%)and 40 cases were male(52.6%).Four cases(5.3%)were younger than 1 year,49 cases(64.5%)were 1-5 years and 23 cases(30.2%)were older than 5 years.Seventeen cases(22.4%)were in stage Ⅲ and59 cases(77.6%)in stage Ⅳ.Chemotherapy was administered to all cases,61 children(80.3%)underwent surgery and 19 children(25.0%)accepted radiotherapy.Forty(52.6%)cases underwent hematopoietic stem cell transplantation and biotherapy.The average survival time of all NB children was 72.2±8.9 months and the median survival time was 34.0 months.The overall one-year survival rate was 78.0%,the two-year survival rate was 60.5%,and the five-year survival rate was 36.9%.The survival time of patients undergoing surgery was longer than that of patients without surgery(38.0 months vs 10.0 months,P<0.001).The survival time of children who received stem cell transplantation and biotherapy was longer than those without stem cell transplantation and biotherapy(138.0 months vs 17.0 months,P<0.001). Conclusion Surgery,stem cell transplantation and biotherapy can prolong the survival of children with advanced NB.