Neuroblastoma With Intraspinal Extension: Health Problems in Long-Term Survivors

作者：Kraal Kathelijne^*; Blom Thomas; Tytgat Lieve; van Santen Hanneke; van Noesel Max; Smets Anne; Bramer Jos; Caron Huib; Kremer Leontien; van der Pal Heleen

来源：Pediatric Blood and Cancer, 2016, 63(6): 990-996.

DOI：10.1002/pbc.25925

• health problems
• intraspinal extension
• long-term survivors
• neuroblastoma

AimTo evaluate the prevalence of health problems in 5-year survivors treated for neuroblastoma (NBL) with intraspinal extension.
Patients and MethodsRetrospective, single center cohort study (using data from Childhood Cancer Registry and medical records) of patients treated for NBL with intraspinal extension (between 1980 and 2007) who survived 5 years after diagnosis. Health problems were graded according to the Common Terminology Criteria for Adverse Events (CTCAEv.3.0).
ResultsAll eligible patients (n = 19) were included (n = 7 no neurological symptoms at diagnosis), median age at diagnosis was 1.2 years (0.6-10.8 years), and median follow-up time was 15.6 years (6.3-29.5 years). Ninety-five percent of survivors had 1 health problem and 48% of survivors had 4 health problem with a mean of 3.8 per survivor. Fifty-three percent of survivors had at least one severe (grade3) or life-threatening/disabling (grade4) health problem. The three most prevalent health problems were kyphosis and/or scoliosis (68% of patients), motor neuropathy (32% of patients), and sensory neuropathy (26% of patients). Of the 13 patients who underwent a laminectomy, 54% (seven of 13) developed a grade 3 and 23% (three of 13) developed a grade 4 health problem. Among six patients, without laminectomy, 17% developed (one of six) a grade 3 and in 17% developed (one of six) a grade 4 health problem.
ConclusionsNinety-five percent of 5-year survivors treated for a childhood intraspinal NBL have health problems. The high prevalence of grade 3 and 4 health problems (especially in the laminectomy group) emphasizes the importance of specialized long-term multidisciplinary follow-up and identifies optimal treatment with limited morbidity and maximal efficacy.

• 出版日期2016-6