Treatment outcomes among high-risk neuroblastoma patients receiving non-immunotherapy regimen: Multicenter study on behalf of the Thai Pediatric Oncology Group
Issued Date
2022-09-01
Resource Type
ISSN
15455009
eISSN
15455017
Scopus ID
2-s2.0-85133866017
Pubmed ID
35560972
Journal Title
Pediatric Blood and Cancer
Volume
69
Issue
9
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pediatric Blood and Cancer Vol.69 No.9 (2022)
Suggested Citation
Suwannaying K., Monsereenusorn C., Rujkijyanont P., Techavichit P., Phuakpet K., Pongphitcha P., Chainansamit S.o., Chotsampancharoen T., Winaichatsak A., Traivaree C., Sathitsamitphong L., Kanjanapongkul S., Komvilaisak P., Sanpakit K., Photia A., Seksarn P., Wiangnon S., Hongeng S. Treatment outcomes among high-risk neuroblastoma patients receiving non-immunotherapy regimen: Multicenter study on behalf of the Thai Pediatric Oncology Group. Pediatric Blood and Cancer Vol.69 No.9 (2022). doi:10.1002/pbc.29757 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85601
Title
Treatment outcomes among high-risk neuroblastoma patients receiving non-immunotherapy regimen: Multicenter study on behalf of the Thai Pediatric Oncology Group
Author's Affiliation
Ramathibodi Hospital
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Maharaj Nakhon Ratchasima Hospital
Khon Kaen Regional Hospital
Queen Sirikit National Institute of Child Health
Phramongkutklao College of Medicine
Prince of Songkla University
Mahasarakham University
Faculty of Medicine, Chulalongkorn University
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Maharaj Nakhon Ratchasima Hospital
Khon Kaen Regional Hospital
Queen Sirikit National Institute of Child Health
Phramongkutklao College of Medicine
Prince of Songkla University
Mahasarakham University
Faculty of Medicine, Chulalongkorn University
Other Contributor(s)
Abstract
Background: Neuroblastoma is the most common extracranial malignant solid tumor during childhood. Despite intensified treatment, patients with high-risk neuroblastoma (HR-NBL) still carry a dismal prognosis. The Thai Pediatric Oncology Group (ThaiPOG) proposed the use of a multimodality treatment to improve outcomes of HR-NBL in non-immunotherapy settings. Methods: Patients with HR-NBL undergoing ThaiPOG protocols (ThaiPOG-NB-13HR or -18HR) between 2013 and 2019 were retrospectively reviewed. Patient demographic data, treatment modalities, outcomes, and prognostic factors were evaluated and analyzed. Results: A total of 183 patients with HR-NBL undergoing a topotecan containing induction regimen were enrolled in this study. During the consolidation phase (n = 169), 116 patients (68.6%) received conventional chemotherapy, while 53 patients (31.4%) underwent hematopoietic stem cell transplantation (HSCT). The 5-year overall survival (OS) and event-free survival (EFS) were 41.2% and 22.8%, respectively. Patients who underwent HSCT had more superior 5-year EFS (36%) than those who received chemotherapy (17.1%) (p =.041), although they both performed similarly in 5-year OS (48.7% vs. 39.8%, p =.17). The variation of survival outcomes was observed depending on the number of treatment modalities. HSCT combined with metaiodobenzylguanidine (MIBG) treatment and maintenance with 13-cis-retinoic acid (cis-RA) demonstrated a desirable 5-year OS and EFS of 65.6% and 58.3%, respectively. Poorly or undifferentiated tumor histology and cis-RA administration were independent factors associated with relapse and survival outcomes, respectively (p <.05). Conclusion: A combination of HSCT and cis-RA successfully improved the outcomes of patients with HR-NBL in immunotherapy inaccessible settings.