4.7 Article

Efficacy of post-induction therapy for high-risk neuroblastoma patients with end-induction residual disease

期刊

CANCER
卷 128, 期 15, 页码 2967-2977

出版社

WILEY
DOI: 10.1002/cncr.34263

关键词

autologous transplantation; neuroblastoma; prognosis; survival; treatment response

类别

资金

  1. Matthew Bittker Foundation
  2. National Institutes of Health/National Cancer Institute [K08CA226237, P30CA014599]

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This multicenter retrospective study investigated the efficacy of different post-induction therapies in high-risk neuroblastoma patients. The results showed that there was no significant difference in survival rates before and after autologous stem cell transplantation (ASCT) for patients who received post-induction therapy. However, patients who did not receive post-induction therapy had lower survival rates.
Background High-risk neuroblastoma patients with end-induction residual disease commonly receive post-induction therapy in an effort to increase survival by improving the response before autologous stem cell transplantation (ASCT). The authors conducted a multicenter, retrospective study to investigate the efficacy of this approach. Methods Patients diagnosed between 2008 and 2018 without progressive disease with a partial response or worse at end-induction were stratified according to the post-induction treatment: 1) no additional therapy before ASCT (cohort 1), 2) post-induction bridge therapy before ASCT (cohort 2), and 3) post-induction therapy without ASCT (cohort 3). chi(2) tests were used to compare patient characteristics. Three-year event-free survival (EFS) and overall survival (OS) were estimated by the Kaplan-Meier method and survival curves were compared by log-rank test. Results The study cohort consisted of 201 patients: cohort 1 (n = 123), cohort 2 (n = 51), and cohort 3 (n = 27). Although the end-induction response was better for cohort 1 than cohorts 2 and 3, the outcomes for cohorts 1 and 2 were not significantly different (P = .77 for EFS and P = .85 for OS). Inferior outcomes were observed for cohort 3 (P < .001 for EFS and P = .06 for OS). Among patients with end-induction stable metastatic disease, 3-year EFS was significantly improved for cohort 2 versus cohort 1 (P = .04). Cohort 3 patients with a complete response at metastatic sites after post-induction therapy had significantly better 3-year EFS than those with residual metastatic disease (P = .01). Conclusions Prospective studies to confirm the benefits of bridge treatment and the prognostic significance of metastatic response observed in this study are warranted.

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