Long-term complications in survivors of advanced stage neuroblastoma
Long-term complications in survivors of advanced stage neuroblastoma
复制标题
DOI：
10.1002/pbc.20331
复制
发表时间：
2005-09-01
影响因子：
3.2
通讯作者：
Sklar, CA
中科院分区：
文献类型：
--
作者：
Laverdière, C;Cheung, NKV;Sklar, CA
背景。很少有研究评估神经母细胞瘤 (NB) 幸存者的晚期影响，特别是那些患有晚期疾病的患者。方法。对单个机构的晚效诊所跟踪的晚期 NB 幸存者队列进行回顾性分析。根据个人的治疗暴露情况定制检测后期效应的筛查测试。结果。该研究包括 63 名幸存者（31 名男性）。诊断时的中位年龄为 3.0 岁。诊断后中位随访时间为 7.06 年。所有患者均接受手术并接受化疗，89% 接受放射治疗 (RT)，62% 接受免疫治疗，56% 接受自体干细胞移植。 95% 的幸存者发现了晚期并发症，包括：听力损失（62%）、原发性甲状腺功能减退症（24%）、卵巢功能衰竭（女性 41%）、肌肉骨骼（19%）和肺部（19%）异常。大多数并发症是中度的，只有 4% 危及生命。与未接受顺铂治疗的幸存者相比，接受顺铂治疗的幸存者出现听力损失的风险更大（OR 9.74；95% Cl：0.9-101.6）。环磷酰胺总剂量大于7.4 g与卵巢功能衰竭相关（P=0.02）。结论。晚期并发症经常发生在晚期 NB 的幸存者中。这些问题大多数都属于轻度至中度严重程度。对这一人群的长期随访（LFTU）和筛查至关重要。
Background. Few studies have assessed late effects in neuroblastoma (NB) survivors, particularly those with advanced stage disease. Methods. Retrospective analysis of a cohort of advanced stage NB survivors followed in a late effect clinic at a single institution. Screening tests to detect late effects were tailored depending on the individual's treatment exposures. Results. The study included 63 survivors (31 males). The median age at diagnosis was 3.0 years. The median follow-up from diagnosis was 7.06 years. All patients had Surgery and received chemotherapy, 89% received radiation therapy (RT), 62% immunotherapy, and 56% autologous stem cell transplant. Late complications were detected in 95% of survivors and included: hearing loss (62%), primary hypothyroidism (24%), ovarian failure (41% of females), musculoskeletal (19%), and pulmonary (19%) abnormalities. The majority of complications were moderate, with only 4% being life-threatening. Survivors who received cisplatin were at greater risk to develop hearing loss compared to those not so treated (OR 9.74; 95% Cl: 0.9-101.6). A total dose of cyclophosphamide greater than 7.4 g was associated with ovarian failure (P=0.02). Conclusions. Late complications occur frequently in survivors of advanced stage NB. The majority of these problems are of mild-moderate severity. Long-term follow-up (LFTU) and screening of this population is essential.