Persistent positive metaiodobenzylguanidine scans after autologous peripheral blood stem cell transplantation may indicate maturation of stage 4 neuroblastoma.
Persistent positive metaiodobenzylguanidine scans after autologous peripheral blood stem cell transplantation may indicate maturation of stage 4 neuroblastoma.
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自体外周血干细胞移植后持续呈阳性的间碘苄胍扫描可能表明 4 期神经母细胞瘤已成熟。
DOI：
10.1080/08880018.2017.1348414
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kawano Y.
中科院分区：
文献类型：
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作者：
Okamoto Y;Kodama Y;Nishikawa T;Rindiarti A;Tanabe T;Nakagawa S;Yoshioka T;Takumi K;Kaji T;Kawano Y.
Metaiodobenzylguanidine （MIBG）扫描是神经母细胞瘤的敏感检测工具。先前发现，3期神经母细胞瘤患者持续的MIBG阳性扫描表明成熟而不是退化。在本研究中，我们评估了这一发现在4期神经母细胞瘤中的意义。回顾性分析了2004年至2014年间在鹿儿岛大学医院连续治疗的15例4期神经母细胞瘤患儿。治疗包括多药化疗、切除、自体外周血干细胞移植（PBSCT）、放疗和维甲酸维持治疗。使用居里评分评估每位患者在治疗期间的MIBG摄取情况。15例患者的5年无事件生存率和总生存率分别为38.9%和58.7%。4例MIBG扫描持续呈阳性的患者接受了自体PBSCT，但在临床过程中出现123i -MIBG摄取减少，存活无进展，他们的无事件生存（EFS）明显优于PBSCT后MIBG扫描呈阴性的患者（5年EFS率：18.2%,p =0.0176）。因此，PBSCT后持续阳性的MIBG扫描并逐渐减少摄取并不总是表明神经母细胞瘤进展，而可能在某些选定的4期神经母细胞瘤病例中（如果不是所有病例）表明肿瘤成熟。
Metaiodobenzylguanidine (MIBG) scans are sensitive testing tools for neuroblastoma. Persistent positive MIBG scans in patients with stage 3 neuroblastoma have previously been found to indicate maturation rather than regression. We assessed the significance of this finding in stage 4 neuroblastoma in the present study. Fifteen consecutive pediatric patients with stage 4 neuroblastoma treated between 2004 and 2014 at the Kagoshima University Hospital were retrospectively examined. Treatment involved a combination of multiagent chemotherapy, resection, autologous peripheral blood stem cell transplantation (PBSCT), radiotherapy, and maintenance therapy with retinoic acid. The MIBG uptake in each patient during treatment was assessed using a Curie score. The 5-year event-free and overall survival rates in 15 patients were 38.9% and 58.7%, respectively. Four patients with persistent positive MIBG scans who underwent autologous PBSCT but experienced decreased123I-MIBG uptake during the clinical course survived without progression, and their event-free survival (EFS) was significantly superior to that of patients who showed negative MIBG scans after PBSCT (5-year EFS rate: 18.2%,p =0.0176). Therefore, persistent positive MIBG scans with gradually decreased uptake after PBSCT do not always indicate neuroblastoma progression, and may instead indicate tumor maturation in some selected cases, if not all cases, of stage 4 neuroblastoma.