Comparative study on the efficacy of different preoperative neoadjuvant chemotherapy regimens in high-risk neuroblastoma

Tian Cong; Xi Hongwei

doi:10.3760/j.issn.1673-4777.2024.10.007

Abstract：Objective To compare the efficacy of different preoperative neoadjuvant chemotherapy regimens in high-risk neuroblastoma(HR-NB).Methods The clinical data of 50 children with HR-NB diagnosed and treated in Shanxi Children's Hospital from January 2016 to January 2019 were collected and retrospectively analyzed.Patients were divided into group A(30 cases)and group B(20 cases)according to different preoperative neoadjuvant chemotherapy regimens.Group A was treated with CAV(cyclophosphamide+adriamycin+vincristine)and CVP(cyclophosphamide+etoposide+cisplatin)before surgery.Group B was treated with CAV(the same drug as group A)and VIP(etoposide+ifosfamide+cisplatin)chemotherapy before surgery.The chemotherapy effect,complete resection rate,adverse reactions and survival were compared between the two groups.Results The effective rate of chemotherapy in group B was significantly higher than that in group A[90.0％(18/20)vs 63.3％(19/30)](P＜0.05).There was no significant difference in the complete resection rate between group B and group A[85.0％(17/20)vs 63.3％(19/30)](P=0.148).The children in both groups tolerated well.The incidences of leukopenia,thrombocytopenia,vomiting,diarrhea,and liver and kidney function damage in group B were lower than those in group A(all P＜0.05).Kaplan-meier survival analysis showed that the 3-year overall survival rate in group B was higher than that in group A(67.2％vs 49.9％,Log-rank x2=3.986,P=0.046).Conclusions Preoperative CAV and VIP alternating chemotherapy regimen may be effective in children with HR-NB,and the adverse reactions can be tolerated.