Scintigraphic response by 123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma
Scintigraphic response by 123I-metaiodobenzylguanidine scan correlates with event-free survival in high-risk neuroblastoma
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DOI：
10.1200/jco.2004.07.144
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发表时间：
2004-10-01
影响因子：
45.3
通讯作者：
Kletzel, M
中科院分区：
文献类型：
--
作者：
Katzenstein, HM;Cohn, SL;Kletzel, M
目的探讨诱导治疗的反应，评估间碘苄基胍（MIBG）和骨显像，与无事件生存期（EFS）在儿童高危神经母细胞瘤（NB）。患者和方法29例高危NB患者进行了前瞻性治疗，强化诱导方案和巩固与三个周期的高剂量治疗与外周血干细胞救援。通过MIBG和骨扫描使用半定量评分系统评价骨显像反应。在诊断时和诱导治疗后的影像学评分的预后意义进行了评估。结果在诊断时MIBG骨显像上有与无骨髓吸收患者的4年EFS率相关的趋势（分别为35% +/-11%v80%+/-18%; P = 0.13）。同样，诊断时骨扫描阳性的患者的EFS比骨扫描阴性的患者更差，尽管差异没有统计学意义（分别为34% +/- 10%和83% +/-15%; P = 0.06）。然而，与评分小于3的患者相比，诱导后MIBG评分大于或等于3的患者的EFS显著更差（0% v58%+/- 11%; P = 0.002）。骨扫描评分和结果之间没有相关性诱导therapeutic.Conclusion MIBG评分大于或等于3诱导治疗后确定一个子集的NB患者谁是可能复发后三个周期的高剂量治疗与外周血干细胞救援，局部放疗，和13-顺式维甲酸。对于诱导治疗反应较差的患者，应考虑替代治疗策略。(C)2004年，美国临床肿瘤学会。
Purpose To investigate whether response to induction therapy, evaluated by metaiodobenzylguanadine (MIBG) and bone scintigraphy, correlates with event-free survival (EFS) in children with high-risk neuroblastoma (NB).Patients and Methods Twenty-nine high-risk NB patients were treated prospectively with an intensive induction regimen and consolidated with three cycles of high-dose therapy with peripheral blood stem-cell rescue. The scintigraphic response was evaluated by MIBG and bone scans using a semi-quantitative scoring system. The prognostic significance of the imaging scores at diagnosis and following induction therapy was evaluated.Results A trend associating worse 4-year EFS rates for patients with versus without osteomedullary uptake on MIBG scintigraphs at diagnosis was seen (35% +/- 11% v 80% +/- 18%, respectively; P = .13). Similarly, patients with positive bone scans at diagnosis had worse EFS than those with negative scans, although the difference did not receive statistical significance (34% +/- 10% v 83% +/- 15%, respectively; P = .06). However, significantly worse EFS was observed in patients with a postinduction MIBG score of greater than or equal to3 compared to those with scores of less than 3 (0% v 58% +/- 11%; P = .002). There was no correlation between bone scan scores and outcome following induction therapy.Conclusion MIBG scores greater than or equal to3 following induction therapy identifies a subset of NB patients who are likely to relapse following three cycles of high-dose therapy with peripheral blood stem-cell rescue, local radiotherapy, and 13-cis-retinoic acid. Alternative therapeutic strategies should be considered for patients with a poor response to induction therapy. (C) 2004 by American Society of Clinical Oncology.