신경모세포종 환자의 재발에 관한 고찰

Abstract

Purpose: Nowadays, survival of neuroblastoma patients has improved by high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT). But, many of these patients experienced treatment failure, and relapse was the most important factor of treatment failure. The aim of this study was to investigate the relation between pattern of relapse and survival of neuroblastoma for 10 years. Methods: Fifty nine neuroblastoma patients were enrolled in the study. Retrospective investigation of medical records was performed. Results: Twenty two patients experienced relapse among total 59 patients. Two patients had relapse two times, and another two patients had two or more relpase sites. Median time from diagnosis to relapse is 16.8 months (2～40 months). According to International Neuroblastoma Staging System (INSS), stage of patients with relapse at diagnosis is as follows; Stage II-2 patients, Stage III-4 patients, and Stage IV-16 patients. 11 patients received high dose chemotherapy followed by autologous PBSCT, and 7 patients (63.6%) of them experienced relapse. 48 patients received only chemotherapy, and 17 patients (35.4%) of them experienced relapse. Sites of relapse are as follows; central nervous system (CNS) 6 patients (22.2%), primary site 4 patients (14.8%), bone 4 patients (14.8%), bone marrow 4 patients (14.8%), distant lymph node 2 patients (7.4%), liver 2 patients (7.4%), and others 5 patients (18.5%). Conclusion: In this study, relapses were observed in about 37% of cases. And, the more relapse, the lesser survivals are observed. Although this single institution result had limitation to generalize, CNS was the most common site of relapse. However, multi-center study for relapse sites of neuroblastoma should be evaluated further.