II конгресс детских врачей
РУз с международным участием
«Актуальные вопросы практической
педиатрии»
288
NEUROBLASTOMA IN CHILDREN:
ANALYSIS OF TREATMENT RESULTS
Sanakbai Zh.
Kazakh National Medical University named after Asfendiyarov
Tulebaeva A.
Kazakh National Medical University named after Asfendiyarov
Tashenova G.T.
Kazakh National Medical University named after Asfendiyarov
Saduova A.T.
Kazakh National Medical University named after Asfendiyarov
Bulabaeva G.E.
Scientific Center of Pediatrics and Pediatric Surgery
Almaty, Kazakhstan
Key words:
neuroblastoma, survival, pediatric therapy, immunotherapy.
Background
Neuroblastoma (NB) is an embryonal tumor of childhood arising from cells
of the sympathetic nervous system. Clinically, the disease is characterized by high
heterogeneity from spontaneous regression to aggressive progression, metastasis
and patient death. It ranks fourth in frequency among solid tumors of childhood.
Purpose of the study:
to analyze the results of treatment of neuroblastoma
according to the NB-2004 protocol in children at the Scientific Center of Pediatrics
and Pediatric Surgery.
Materials and methods
The results of treatment of 150 patients with NB who were treated in the
Department of Oncology and Hematology of the Scientific Center of Pediatrics and
Pediatric Surgery from 2018 to 2022 were analyzed. Statistical analysis was
performed using Excel 2010 and IBM SPSS Statistics 22.0. A comparative analysis
was carried out according to such parameters as gender, age at diagnosis, tumor
location, stage of the disease and molecular genetic factors.
Results
Of the 150 patients, 78 (52%) were boys and 72 (48%) were girls. The
average age of the observed patients was 2.2 years, with a predominance of
children aged 1-5 years. In 122 patients, the tumor was localized primarily in the
abdominal cavity, in 14 patients in the mediastinum, in 3 patients in the neck, and
in 11 patients there was a primary generalized disease. According to staging,
there were 20 patients in stage I, 9 in stage II, 18 in stage III, 93 in stage IV
(the most common), and 10 in stage 4s. Stratification based on the NB-2004
protocol included 33 patients (22%) were low risk, 18 (12%) were intermediate
risk, and 99 (66%) were high risk.
II конгресс детских врачей РУз с международным участием
«Актуальные вопросы практической
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289
Since March 2022, the NB-2004 protocol has been implemented in
Kazakhstan, offering immunotherapy to patients with high-risk neuroblastoma.
Currently, 13 children have received or are receiving dinutuximab beta, with only
1 patient at stage III, and the rest at stage IV. Three patients had a relapse with
stabilization of the process. A total of 35 cycles were performed using a 10-day
regimen.
When analyzing the results of therapy by risk group, overall survival was
100% for the observation group, 85.7% for the intermediate-risk group and
43.1% for the high-risk group. The overall five-year survival rate for the entire
group was 56.7%.
Conclusions
Late diagnosis due to insufficient oncopediatric alertness of doctors is the
main reason for the severity of neuroblastoma, leading to a worse prognosis. The
therapeutic protocol was less effective in the high-risk group, consistent with
global results. The introduction of immunotherapy at the Research Center for
Pediatrics and Pediatric Surgery gives hope for improving survival rates among
patients with high-risk neuroblastoma.
