Background: High-risk Neuroblastoma (N. B) patients have a poor outcome with 5-year survival rates of 50%. Patients with stage 4 disease or MYC-N amplification showed post-progression 5y O. S. of 7% to 8%. Other studies proved the same dismal outcome in high-risk relapsed patients. This study aimed to detect the O. S. and EFS of N. B patients post-progression. Secondary to explore, if initial prognostic factors, high-intensity salvage therapy and other treatment modalities could improve the outcome of progressive /refractory disease. Methods: Seventy patients of high-risk Neuroblastoma needed salvage therapy, either due to refractory/progressive disease or irresectability of the primary tumor. Initial prognostic factors and different treatment strategies were collected and correlated with the outcome. Results: Fifty-seven (57 /70) patients died from progressive disease with a median survival of 20.6 months with three y EFS and O. S. of 9.5% and 35.7%, respectively. Objective response (CR/VGPR/PR) post-induction, consolidation by HSCT, radiotherapy, and maintenance therapy; affected survival significantly post salvage therapy. Multivariate analysis revealed that the only independent factor that significantly affected O. S was maintenance therapy. The independent factors that affected the EFS negatively were the presence of liver metastases, poor response post-induction, and not administering radiotherapy. Conclusion: Response to induction had a significant impact on the outcome post salvage. Salvage therapy did not improve the outcome for those with inadequate induction response. Initial front-line targeted therapy like antiGD2 is needed to improve the outcome, especially for chemo-resistant ones.
| Published in | Cancer Research Journal (Volume 9, Issue 2) |
| DOI | 10.11648/j.crj.20210902.11 |
| Page(s) | 85-91 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Salvage, Neuroblastoma, High Risk-Low Middle, Income Countries
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APA Style
Ahmed Elhemaly, Ahmed Fathalla, Mahmed Elhusseny, Mohamed Fawzy. (2021). Impact of Initial Prognostic Factors and Intensity of Salvage Therapy on the Outcome of Progressive / Refractory High-Risk Neuroblastoma. Cancer Research Journal, 9(2), 85-91. https://doi.org/10.11648/j.crj.20210902.11
ACS Style
Ahmed Elhemaly; Ahmed Fathalla; Mahmed Elhusseny; Mohamed Fawzy. Impact of Initial Prognostic Factors and Intensity of Salvage Therapy on the Outcome of Progressive / Refractory High-Risk Neuroblastoma. Cancer Res. J. 2021, 9(2), 85-91. doi: 10.11648/j.crj.20210902.11
AMA Style
Ahmed Elhemaly, Ahmed Fathalla, Mahmed Elhusseny, Mohamed Fawzy. Impact of Initial Prognostic Factors and Intensity of Salvage Therapy on the Outcome of Progressive / Refractory High-Risk Neuroblastoma. Cancer Res J. 2021;9(2):85-91. doi: 10.11648/j.crj.20210902.11
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Download@article{10.11648/j.crj.20210902.11,
author = {Ahmed Elhemaly and Ahmed Fathalla and Mahmed Elhusseny and Mohamed Fawzy},
title = {Impact of Initial Prognostic Factors and Intensity of Salvage Therapy on the Outcome of Progressive / Refractory High-Risk Neuroblastoma},
journal = {Cancer Research Journal},
volume = {9},
number = {2},
pages = {85-91},
doi = {10.11648/j.crj.20210902.11},
url = {https://doi.org/10.11648/j.crj.20210902.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20210902.11},
abstract = {Background: High-risk Neuroblastoma (N. B) patients have a poor outcome with 5-year survival rates of 50%. Patients with stage 4 disease or MYC-N amplification showed post-progression 5y O. S. of 7% to 8%. Other studies proved the same dismal outcome in high-risk relapsed patients. This study aimed to detect the O. S. and EFS of N. B patients post-progression. Secondary to explore, if initial prognostic factors, high-intensity salvage therapy and other treatment modalities could improve the outcome of progressive /refractory disease. Methods: Seventy patients of high-risk Neuroblastoma needed salvage therapy, either due to refractory/progressive disease or irresectability of the primary tumor. Initial prognostic factors and different treatment strategies were collected and correlated with the outcome. Results: Fifty-seven (57 /70) patients died from progressive disease with a median survival of 20.6 months with three y EFS and O. S. of 9.5% and 35.7%, respectively. Objective response (CR/VGPR/PR) post-induction, consolidation by HSCT, radiotherapy, and maintenance therapy; affected survival significantly post salvage therapy. Multivariate analysis revealed that the only independent factor that significantly affected O. S was maintenance therapy. The independent factors that affected the EFS negatively were the presence of liver metastases, poor response post-induction, and not administering radiotherapy. Conclusion: Response to induction had a significant impact on the outcome post salvage. Salvage therapy did not improve the outcome for those with inadequate induction response. Initial front-line targeted therapy like antiGD2 is needed to improve the outcome, especially for chemo-resistant ones.},
year = {2021}
}
TY - JOUR T1 - Impact of Initial Prognostic Factors and Intensity of Salvage Therapy on the Outcome of Progressive / Refractory High-Risk Neuroblastoma AU - Ahmed Elhemaly AU - Ahmed Fathalla AU - Mahmed Elhusseny AU - Mohamed Fawzy Y1 - 2021/04/07 PY - 2021 N1 - https://doi.org/10.11648/j.crj.20210902.11 DO - 10.11648/j.crj.20210902.11 T2 - Cancer Research Journal JF - Cancer Research Journal JO - Cancer Research Journal SP - 85 EP - 91 PB - Science Publishing Group SN - 2330-8214 UR - https://doi.org/10.11648/j.crj.20210902.11 AB - Background: High-risk Neuroblastoma (N. B) patients have a poor outcome with 5-year survival rates of 50%. Patients with stage 4 disease or MYC-N amplification showed post-progression 5y O. S. of 7% to 8%. Other studies proved the same dismal outcome in high-risk relapsed patients. This study aimed to detect the O. S. and EFS of N. B patients post-progression. Secondary to explore, if initial prognostic factors, high-intensity salvage therapy and other treatment modalities could improve the outcome of progressive /refractory disease. Methods: Seventy patients of high-risk Neuroblastoma needed salvage therapy, either due to refractory/progressive disease or irresectability of the primary tumor. Initial prognostic factors and different treatment strategies were collected and correlated with the outcome. Results: Fifty-seven (57 /70) patients died from progressive disease with a median survival of 20.6 months with three y EFS and O. S. of 9.5% and 35.7%, respectively. Objective response (CR/VGPR/PR) post-induction, consolidation by HSCT, radiotherapy, and maintenance therapy; affected survival significantly post salvage therapy. Multivariate analysis revealed that the only independent factor that significantly affected O. S was maintenance therapy. The independent factors that affected the EFS negatively were the presence of liver metastases, poor response post-induction, and not administering radiotherapy. Conclusion: Response to induction had a significant impact on the outcome post salvage. Salvage therapy did not improve the outcome for those with inadequate induction response. Initial front-line targeted therapy like antiGD2 is needed to improve the outcome, especially for chemo-resistant ones. VL - 9 IS - 2 ER -
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