Role of surgery in delayed local treatment for <scp>INSS</scp> 4 neuroblastoma

Uehara, Shuichiro; Yoneda, Akihiro; Oue, Takaharu; Nakahata, Kengo; Zenitani, Masahiro; Miyamura, Takako; Hashii, Yoshiko; Fukuzawa, Masahiro; Okuyama, Hiroomi

doi:10.1111/ped.13349

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…Metastatic disease is found in about half the cases at the time of diagnosis, with most frequent sites of metastatic disease being bone and bone marrow, involving osseous structures from the skull and spine to appendicular skeleton, followed by liver, and skin (3). (3,6). Previous studies showed that 123 I-single photon emission computed tomography combined with CT (SPECT/CT) imaging provides better assessment of metastatic disease as compared to planar 123 I-MIBG imaging due to improved anatomical localization and improved lesion contrast in SPECT/CT versus planar imaging (7,8).…”

Section: Introductionmentioning

confidence: 99%

¹²⁴I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

et al. 2020

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The metaiodobenzylguanidine (MIBG) scan is one of the most sensitive noninvasive lesion detection modalities for neuroblastoma. Unlike 123 I-MIBG, 124 I-MIBG allows high-resolution positron emission tomography (PET). We evaluated 124 I-MIBG PET/CT for its diagnostic performance directly compared to paired 123 I-MIBG scans. Methods: Prior to 131 I-MIBG therapy, standard 123 I-MIBG scans (5.2 MBq/kg) that include whole-body (anterior-posterior) planar scans and focused field of view (FOV) single photon emission computed tomography combined with CT (SPECT/CT) as well as whole-body 124 I-MIBG PET/CT (1.05 MBq/kg) were performed in 7 patients. After therapy, 2 of 7 patients also completed 124 I-MIBG PET/CT as well as paired 123 I-MIBG planar and SPECT/CT scans. One patient received 124 I-MIBG PET/CT only after therapy. We evaluated all 8 patients who showed at least one 123 I-MIBG-positive lesion with a total of 10 scans. In 8 pairs, 123 I-MIBG and 124 I-MIBG were performed within 1 month of each other. Locations of identified lesions, the number of total lesions, and the Curie scores were recorded for 123 I-MIBG and 124 I-MIBG scans. Finally, for five patients who completed at least three PET/CT scans after administration of 124 I-MIBG, we estimated the effective dose of 124 I-MIBG. Results: 123 I-MIBG whole-body planar scans, focused FOV SPECT/CT scans, and whole-body 124 I-MIBG PET scans found 25, 32, and 87 total lesions respectively. There was a statistically significant difference in detecting lesions on 124 I-MIBG PET/CT as compared to 123 I-MIBG planar scans (P < 0.0001) and 123 I-MIBG SPECT/CT (P < 0.0001). The Curie scores were also higher for 124 I-MIBG PET/CT as compared to those for 123 I-MIBG planar and SPECT/CT in 6 out of 10 scans. 124 I-MIBG PET/CT demonstrated better detection of lesions throughout the body including chest, spine, head and neck, and extremities. The effective dose estimated for patient-specific 124 I-MIBG was approximately ten times that of 123 I-MIBG; however, given that we administered a very low activity of 124 I-MIBG (1.05 MBq/kg), the effective dose was only approximately twice that of 123 I-MIBG despite the large difference in half-lives (100 vs. 13.2 hours). Conclusion: The first in human use of low-dose 124 I-MIBG PET for monitoring disease burden demonstrated superior tumor detection capability as compared to 123 I-MIBG planar and SPECT/CT scans.

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Section: Introductionmentioning

confidence: 99%

¹²⁴I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

et al. 2020

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“…INSS is one of the most commonly used NB staging systems in clinical practice. Patients with NB in the INSS stages III-IV usually suffer from tumor infiltration or lymph node and distant metastases, and simple surgical treatment is considered insufficient for complete removal of the lesion, resulting in poor prognosis [ 12 , 13 ]. Prior research has found that preoperative adjuvant chemotherapy can effectively facilitate surgical resection and prolong the 5-year survival of the patients [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Surgery Combined with Different Chemotherapy on Matrix Metalloproteinase-9 and Tissue Inhibitors of Metalloproteinase-1 in Children with Neuroblastoma

Wang

Yin

et al. 2022

Journal of Oncology

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Background. Neuroblastoma (NB) is a common extracranial malignancy in children and accounts for 15% of all cancer-related deaths in children, with the 5-year survival of patients in an advanced stage being lower than 40%. Preoperative adjuvant chemotherapy has been reported to facilitate surgical resection and improve the 2-year survival of patients. Objective. To analyze the efficacy of surgery plus different chemotherapy on children with NB and to investigate the correlation of matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of metalloproteinase-1 (TIMP-1) with chemotherapy efficacy. Methods. From April 2005 to May 2017, a total of 92 cases of NB treated in our hospital were assessed for eligibility and recruited. They were assigned at a ratio of 1: 1 to receive either CAV (cyclophosphamide + vincristine + adriamycin) (group A) and EP (etoposide + cisplatin) alternately or TOPO (topotecan) + CTX (cytoxan) + CiE (etoposide + cisplatin) + CPV (cyclophosphamide + pirarubicin + vincristine) (group B). The outcome measures include chemotherapy efficacy, surgical resection rates, complications, 2-year recurrence, and 2-year survival. The levels of NK cells, CD4+/CD8+ cells, MMP-9, TIMP-1, and urine catecholamine (VMA) in peripheral blood of patients before and after initial chemotherapy were determined to analyze the correlation of MMP-9, TIMP-1, and VMA with the efficacy of chemotherapy. Results. The two groups had similar efficacy (84.00% vs. 95.24%) and surgical resection rates (60.00% vs. 61.90%) after the initial chemotherapy ( P > 0.05 ). Surgery for all eligible patients was successful after second chemotherapy. All eligible patients showed myelosuppression after chemotherapy, including 48 cases with stages I-II (52.17%) and 44 cases with stages III-IV (47.83%). The ratio of CD4+/CD8+ cells, MMP-9, TIMP-1, and VMA expression levels in peripheral blood of patients decreased ( P < 0.05 ) after chemotherapy, and the ratio of CD4+/CD8+ cells was further reduced after surgery ( P < 0.05 ), while natural killer (NK) cells levels increased ( P < 0.05 ). However, intergroup differences were absent in the incidence of myelosuppression, CD4+/CD8+ cell ratio, NK cells, MMP-9, TIMP-1, and VMA expression levels ( P > 0.05 ). MMP-9 and TIMP-1 were positively correlated with VMA ( P < 0.05 ), and the expression levels of MMP-9 and TIMP-1 and VMA after chemotherapy were negatively correlated with chemotherapy efficiency ( P < 0.05 ). Patients with high expressions of MMP-9, TIMP-1, and VMA were associated with lower 2-year survival versus those with low expressions ( P < 0.05 ). Conclusion. Surgery plus chemotherapy for children with NB yields a promising clinical efficacy and a favorable surgical resection outcome. MMP-9 and TIMP-1 may be the potential biological indicators for chemotherapy efficiency and have a reference value for following surgical treatment of patients.

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“…[ 28 ] Hence, the treatment strategy may have advantages in terms of surgical invasiveness and the rates of postoperative complications and recurrence. [ 29 ] Nevertheless, other study showed no substantial survival benefit in patients with high-risk NB undergoing gross total tumor resection. [ 30 ] Multidisciplinary intensive treatment was essential, especially for patients who received STR.…”

Section: T Reatmentmentioning

confidence: 99%

Advances in the Surgical Treatment of Neuroblastoma

Luo

Cui

Yang

et al. 2018

Chinese Medical Journal

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Objective:This study was to review the efficacy of surgical resections in different clinical situations for a better understanding of the meaning of surgery in the treatment of neuroblastoma (NB).Data Sources:The online database ScienceDirect (2016–2018) was utilized. The search was conducted using the keywords “neuroblastoma,” “neuroblastoma resection,” “neuroblastoma surgery,” and “high-risk neuroblastoma.”Study Selection:We retrospectively analyzed of patients who underwent surgical resections in different clinical situations. The article included findings from selected relevant randomized controlled trials, systematic reviews, and meta-analyses or good-quality observational studies. Abstracts only, letters, and editorial notes were excluded. Full-text articles and abstracts were extracted and reviewed to identify key articles discussing surgery management of NB, which were then selected for critical analysis.Results:A total of 7800 English language articles were found containing references to NB (2016–2018). The 163 articles were searched which were related to the surgical treatment of NB (2016–2018). Through the analysis of these important articles, we found that the treatments of NB at low- and intermediate-risk groups were basically the same. High-risk patients remained controversial.Conclusions:NB prognosis varies tremendously based on the stage and biologic features of the tumor. After reviewing the relevant literature, patients with low-risk disease are often managed with surgical resection or observation alone with tumors likely to spontaneously regress that are not causing symptoms. Intermediate patients are treated with chemotherapy with the number of cycles depending on their response as well as surgical resection of the primary tumor. High-risk patients remain controversial. Multidisciplinary intensive treatment is essential, especially for patients who received subtotal tumor resection. Minimally invasive surgery for the treatment of NBs without image-defined risk factors in low- to high-risk patients is safe and feasible and does not compromise the treatment outcome. We conclude that ≥90% resection of the primary tumor is both feasible and safe in most patients with high-risk NB. New targeted therapies are crucial to improve survival.

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Role of surgery in delayed local treatment for INSS 4 neuroblastoma

Abstract: Gross total resection/subtotal resection with local irradiation may be a safe and effective delayed local treatment for INSS 4 NB.

Cited by 7 publications

References 13 publications

¹²⁴I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

¹²⁴I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

Effects of Surgery Combined with Different Chemotherapy on Matrix Metalloproteinase-9 and Tissue Inhibitors of Metalloproteinase-1 in Children with Neuroblastoma

Advances in the Surgical Treatment of Neuroblastoma

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Role of surgery in delayed local treatment for INSS 4 neuroblastoma

Abstract: Gross total resection/subtotal resection with local irradiation may be a safe and effective delayed local treatment for INSS 4 NB.

Cited by 7 publications

References 13 publications

124I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

124I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

Effects of Surgery Combined with Different Chemotherapy on Matrix Metalloproteinase-9 and Tissue Inhibitors of Metalloproteinase-1 in Children with Neuroblastoma

Advances in the Surgical Treatment of Neuroblastoma

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¹²⁴I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma

¹²⁴I-MIBG PET/CT to Monitor Metastatic Disease in Children with Relapsed Neuroblastoma