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International Journal of Clinical Oncology

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01.06.2013 | Original Article

Successful treatment of infants with localized neuroblastoma based on their MYCN status

verfasst von: Tomoko Iehara, Minoru Hamazaki, Tatsuro Tajiri, Yoshifumi Kawano, Michio Kaneko, Hitoshi Ikeda, Hajime Hosoi, Tohru Sugimoto, Tadashi Sawada, Japanese Infantile Neuroblastoma Cooperative Study Group

Erschienen in: International Journal of Clinical Oncology | Ausgabe 3/2013

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Abstract

Background

The aim of this study was to evaluate the effectiveness of post-surgical chemotherapy for infants with localized neuroblastoma without MYCN amplification (MNA), and determine whether risk classification using MNA is reasonable.

Methods

Four hundred and fourteen eligible patients were registered between 1998 and 2004. Resectable patients in stage 1 and 2A/2B were treated by surgical resection only. Unresectable patients in stage 3 without MNA received either 6 cycles of regimen A or 3 cycles of regimen A plus 3 cycles of regimen C2; regimen A consisted of low doses of cyclophosphamide and vincristine and regimen C consisted of cyclophosphamide, vincristine and pirarubicin before surgical resection. The resectable and unresectable patients were randomly selected to receive post-surgical chemotherapy. The patients with MNA received intensive chemotherapy regimen D2, consisting of cyclophosphamide, vincristine, pirarubicin and cisplatin, and some of them received high-dose chemotherapy with stem cell transplantation.

Results

The 5-year event-free survival (5-EFS) rates of stage 1 and 2A/2B patients without MNA were 97.2 and 89.0% respectively (p = 0.02). A total of 31 patients in stage 3 without MNA received post-surgical chemotherapy, and 30 patients did not. The 5-EFS rates of these two groups (96.0 and 96.2%, respectively) were not significantly different (p = 0.869). The 5-EFS rate for localized patients with MNA (n = 6) was 50.0%, and that of patients without MNA was 95.0% (p < 0.001).

Conclusion

Post-surgical chemotherapy was therefore unnecessary for localized patients without MNA. This treatment strategy using MNA is considered to be appropriate in infants.

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Sawada T, Nishi M, Takeda T et al (1998) Mass screening for neuroblastoma in Japan. Med Pediatr Oncol 31:429–434CrossRef

Sawada T, Hirayama M, Nakata T et al (1984) Mass screening for neuroblastoma in infants in Japan. Interim report of a mass screening group. Lancet 2:271–273PubMedCrossRef

Hachitanda Y, Ishimoto K, Hata J et al (1994) One hundred neuroblastomas detected through a mass screening system in Japan. Cancer 74:3223–3226PubMedCrossRef

Castleberry RP, Shuster JJ, Altshluer G et al (1992) Infants with neuroblastoma and regional lymph node metastases have a favorable outlook after limited postoperative chemotherapy: a Pediatric Oncology Group Study. J Clin Oncol 10:1299–1304PubMed

Garaventa A, Boni L, Lo Piccolo MS et al (1993) Localized but unresectable neuroblastoma: treatment and outcome of 145 cases. Italian Cooperative Group for Neuroblastoma. J Clin Oncol 1:1770–1779

Matsumura T, Sawada T, Shikata T et al (1997) Management for neuroblastoma infants in Japan. Korean J Pediatr Hematol Oncol 4:18–28

Brodeur GM, Pritchrd J Berthold F et al (1993) Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment. J Clin Oncol 11:1466–1477PubMed

Shimada H, Umehara S, Monobe Y et al (2001) International neuroblastoma pathology classification for prognostic evaluation of patients with peripheral neuroblastic tumors: a report from the Children’s Cancer Group. Cancer 92:2451–2461PubMedCrossRef

Brodeur GM, Seeger RC, Schwab M et al (1984) Amplification of N-myc in untreated human neuroblastomas correlates with advanced disease stage. Science 224:1121–1124PubMedCrossRef

10.

Suita S, Tajiri T, Kaneko M et al (2007) Implications of MYCN amplification in patients with stage 4 neuroblastoma who undergo intensive chemotherapy. J Pediatr Surg 42:489–493PubMedCrossRef

11.

Perez CA, Matthay KK, Atkinson JB et al (2000) Biologic variables in the outcome of stages I and II neuroblastoma treated with surgery as primary therapy: a Children’s Cancer Group Study. J Clin Oncol 18:18–26PubMed

12.

Alvarado CS, London WB, Look AT et al (2000) Natural history and biology of stage A neuroblastoma: a Pediatric Oncology Group Study. J Pediatr Hematol Oncol 22:197–205PubMedCrossRef

13.

Iehara T, Hosoi H, Akazawa K et al (2006) MYNC gene amplification is a powerful prognostic factor even in infantile neuroblastoma detected by mass screening. Br J Cancer 94:1510–1515PubMedCrossRef

14.

Cohn SL, Pearson AD, London WB et al (2009) The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force Report. J Clin Oncol 27:289–297PubMedCrossRef

15.

Bagatell R, Beck-Popovic M, London WB et al (2009) Significance of MYCN amplification in international neuroblastoma staging system stage 1 and 2 neuroblastoma: a report from the International Neuroblastoma Risk Group database. J Clin Oncol 27:365–370PubMedCrossRef

16.

Simon T, Spitz R, Faldum A et al (2004) New definition of low-risk neuroblastoma using stage, age, and 1p and MYCN status. J Pediatr Hematol Oncol 26:791–796PubMed

17.

Rubie H, Cozo C, Plantaz D et al (2003) Localized and neuroblastoma in infants: excellent outcome with low-dose primary chemotherapy. Br J Cancer 89:1605–1609PubMedCrossRef

18.

De Bernardi B, Conte M, Mancini A et al (1995) Localized resectable neuroblastoma: results of the second study of the Italian Cooperative Group for Neuroblastoma. J Clin Oncol 13:884–893PubMed

19.

Matthay KK, Perez C, Seeger RC et al (1998) Successful treatment of stage III neuroblastoma based on prospective biologic staging: a Children’s Cancer Group Study. J Clin Oncol 16:1256–1264PubMed

20.

Cecchetto G, Mosseri V, De Bernardi B et al (2005) Surgical risk factors in primary surgery for localized neuroblastoma: the LNESG1 Study of the European International Society of Pediatric Oncology Neuroblastoma Group. J Clin Oncol 23:8483–8489PubMedCrossRef

21.

Shamberger RC, Smith EI, Joshi VV et al (1998) The risk of nephrectomy during local control in abdominal neuroblastoma. J Pediatr Surg 33:161–164PubMedCrossRef

22.

Monclair T, Brodeur GM, Ambros PF et al (2009) The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol 27:298–303PubMedCrossRef

23.

Tanaka M, Kigasawa H, Kato K et al (2010) A prospective study of a long-term follow-up of an observation program for neuroblastoma detected by mass screening. Pediatr Blood Cancer 54:573–578PubMed

24.

Hero B, Simon T, Spitz R et al (2008) Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97. J Clin Oncol 26:1504–1510PubMedCrossRef

Titel: Successful treatment of infants with localized neuroblastoma based on their MYCN status
verfasst von: Tomoko Iehara
Minoru Hamazaki
Tatsuro Tajiri
Yoshifumi Kawano
Michio Kaneko
Hitoshi Ikeda
Hajime Hosoi
Tohru Sugimoto
Tadashi Sawada
Japanese Infantile Neuroblastoma Cooperative Study Group
Publikationsdatum: 01.06.2013
Verlag: Springer Japan
Erschienen in: International Journal of Clinical Oncology / Ausgabe 3/2013
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-012-0391-y

Springer Medizin

Successful treatment of infants with localized neuroblastoma based on their MYCN status