■神经母细胞瘤4S是在12个月以下儿童中发现的一种罕见的转移性神经母细胞瘤亚型,以肝脏为特征,皮肤,或者骨髓转移瘤.虽然患者的预后普遍良好,肝转移的快速进展可导致危及生命的器官功能不全。在这种情况下,需要立即进行化疗或放疗。鉴于最近放射治疗利用率的下降,这项研究旨在重新评估其作用,评估其有效性和毒性。
■我们进行了系统评价和机构回顾性分析,以评估神经母细胞瘤4S患者的放疗治疗肝肿大。该研究包括来自文献的164名患者和来自我们机构队列的16名患者的数据。我们提取并分析了短期和长期结果的数据,以及放疗引起的毒性报道。
■我们的机构数据显示,81%的患者对低剂量放疗有反应,中位剂量为450cGy,分三个部分进行,导致肝脏收缩和症状缓解。在系统回顾的基础上,1年生存率为80%,5年生存率为75%。目前的低剂量放射治疗没有观察到严重的毒性;然而,报告1例诱发的继发性恶性肿瘤。
■放射治疗是治疗神经母细胞瘤4S患者肝肿大的有效方法,成功率约为80%。尽管给婴儿服用了,450-600cGy的低剂量不会导致与肾脏相关的毒性,肝脏,或姿势缺陷。
UNASSIGNED: Neuroblastoma 4S is a rare subtype of metastatic neuroblastoma found in children younger than 12 months, characterized by liver, skin, or bone marrow metastases. While the prognosis for patients is generally favorable, rapid progression of liver metastases can lead to life-threatening organ insufficiency. In such cases, immediate treatment with chemotherapy or radiotherapy is necessary. Given the recent decline in radiotherapy utilization, this study aims to reassess its role, evaluating its effectiveness and toxicity.
UNASSIGNED: We conducted a systematic review and an institutional retrospective analysis to assess the use of radiotherapy for
hepatomegaly in patients with neuroblastoma 4S. The study included data from 164 patients from the literature and 16 patients from our institutional cohort. We extracted and analyzed data on short- and long-term outcomes, as well as reports of radiotherapy-induced toxicity.
UNASSIGNED: Our institutional data showed that 81 % of patients responded to low-dose radiotherapy administered at a median dose of 450 cGy in three fractions, resulting in liver shrinkage and symptom resolution. Based on the systematic review, 1-year survival rate was 80 %, while 5-year survival rate was 75 %. No serious toxicity was observed with the current low-dose radiotherapy; however, one case of induced secondary malignancy was reported.
UNASSIGNED: Radiation therapy is an effective treatment modality for
hepatomegaly in patients with neuroblastoma 4S, with a success rate of about 80 %. Despite being administered to infants, a low dose of 450-600 cGy does not result in toxicity related to the kidneys, liver, or posture defects.