目的 探讨含伊立替康联合环磷酰胺方案对晚期神经母细胞瘤(neuroblastoma ，NB)患者的临床疗效及安全性。方法 回顾性总结分析武警总医院儿科自2008-05至2015-09收治的采用含伊立替康联合环磷酰胺方案(观察组)治疗的18例晚期神经母细胞患者临床资料，并与采用未含伊立替康联合环磷酰胺方案(对照组)治疗的18例晚期NB患儿进行比较，分析并总结伊立替康联合环磷酰胺治疗晚期NB临床疗效和安全性。结果 至2015-09-30，(1)疾病总有效率观察组(55.6%)高于对照组(27.8%)，差异无统计学意义;疾病总控制率观察组(77.8%)高于对照组(38.9%)，差异有统计学意义(P<0.05);(2)中位无进展生存期、中位总生存期观察组(31个月，28个月)较对照组高(15个月，17个月)，差异有统计学意义(P＜0.05);(3)随访时间达1年患者，观察组15例，对照组18例，1年生存率观察组(100%)高于对照组(61.1%)，差异有统计学意义(P＜0.05);(4)用药期间不良事件主要包括恶心、呕吐等消化道症状及骨髓抑制相关的血液学毒性，观察组发生血小板下降、贫血、转氨酶增高较对照组少。结论 伊立替康联合环磷酰胺用于治疗晚期神经母细胞瘤，疗效肯定，且未发生严重的毒副反应。
Abstract
Objective To study the clinical efficacy of irinotecan plus cyclophosphamide in children with advanced neuroblastoma (NB).Methods We summarized clinical data of 18 children with advanced neuroblastoma who were treated with irinotecan plus cyclophosphamide (observation group) between May 2008 to September 2015 in the General Hospital of Peoples Armed Forces. Another 18 cases with advanced neuroblastoma received non irinotecan plus cyclophosphamide chemotherapy were employed as control group.The efficacy and safety were reviewed.Results As of September 30,2015, The disease control rate in observation group(55.56%)was higher than that in control group(27.8%); The responsive rate in observation group (77.78%) was higher than that in control group (38.9%).The progression-free survival and overall survival of observation group (31 months,28 months) was higher than that in control group(15 months,17 months)(P<0.05).In the observation group, 15 cases were followed up for 1 year, 18 cases in the control group were followed up for 1 year. The 1 year survival rate in the observation group (100%) was higher than that in the control group (61.1%,P<0.05). The dose-limiting toxicity(DLT) included nausea, vomiting, diarrhea and other gastrointestinal symptoms and bone marrow suppression of hematology toxicity. Thrombocytopenia, anemia, elevated aminotransferase in control group were higher than that in the observation group (P<0.05).Conclusions Irinotecan combined with cyclophosphamide used for treatment of advanced NB has certain curative effects without extra side effects.
关键词
神经母细胞瘤 /
伊立替康 /
环磷酰胺 /
疗效 /
安全性
Key words
neuroblastoma /
irinotecan /
cyclophosphamide /
curative effect /
safety
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