Different Treatment Modalities Impact On The Prognosis Of Children With Neuroblastoma.

Objective:Discussion of simple chemotherapy,postoperative chemotherapy, preoperative and postoperative chemotherapy these three different treatment modalities impact on the Prognosis of children with neuroblastoma though the clinical data analysis of 54 NB patients who received treatment in our department.Methods:We collected the data of 54 neuroblastoma cases hospitalized from January 1990 to December 2004.Seven patients received simple chemotherapy,eleven patients received postoperative chemotherapy,and 36 patiens received both preoperative and postoperative chemotherapy.Items of research:B-scan ultrasound,CT,Bone marrow smears,urinary vanillylmandelic acid,rate of integrity resection,one and two-year surviving rate.Statistics: Chi-square test,log-rank test,two-group completely randomized design T-test, using SPSS statistic software statistical analysis,P＜0.05 indicated significant.Results:①11 patients inspected with B-scan ultrasound before and after chemotherapy,through paired t-test,P=0.002(P＜0.05),compared before chemotherapy and after chemotherapy,the difference was statistically significant.②8 patients inspected with CT scanning before and after chemotherapy,through paired t-test,P=0.00(P＜0.05)compared before and after chemotherapy,the difference was statistically significant.③Bone manrrow smears in 23 cases,the positive rate was 17/23(73.91%),24-hour urinary vanillylmandelic acid(VMA)Colorimetric Determination of biochemical in 37 cases,the positive rate was 16/37(43.24%),Compared the two groups, P=0.01(P＜0.05),the difference was statistically significant.④10 patients inspected 24-hour urinary vanillylmandelic acid(VMA)before and after chemotherapy,through paired t-test,P=0.027(P＜0.05)compared before and after chemotherapy,the difference was statistically significant.⑤The excision rate of with and without pre-operation chemotherapy were 63.88%(23/36)and 18.18%(2/11)respectively,P=0.03(P＜0.05)There were significant difference.⑥One-year-survival rate are 78.78%(28/36),45.45%(5/11)and 28.57%(2/7). Two-year-survival rate are 44.44%(16/36)9.09%(1/11)and 0(0/7).The difference among survival curve those above are statistical significant by the methods of log ranking test.P=0.001(P＜0.05)the difference was statistically significant.Conclusion:①Diagnosis of advanced neuroblastoma patients,bone marrow smears was more meaningful than VMA inspection.②Preoperative chemotherapy can significantly reduce tumor size,and can turn some children' s bone marrow biopsy inspection to negative.③Pre-surgery chemotherapy,delayed surgery could increase the excision rate and one-and two-year survival rate.④Pre-surgery chemotherapy could increase one-and two-year survival rate.