Relapsed neuroblastoma in the central nervous system, a single-center,
retrospective study
Abstract
Background: The incidence of relapsed neuroblastoma (NB) in the central
nervous system (CNS) is less than 20%. Here, we presented eleven cases
with CNS relapsed NB to better understand the CNS relapsed NB. Methods:
Medical records from NB patients between January 1st, 2010 and December
31st, 2017 were reviewed to examine those diagnosed with CNS relapsed
NB. The following patient information was extracted, including age,
gender, histological subtyping, tumor stage, risk group, biomarkers,
chemotherapy regimen and dosage, surgery details, treatment outcomes and
follow-up, clinical manifestations of CNS relapsed NB, treatment
protocols for CNS relapsed NB, and patient outcomes (including the cause
of death). Results: From January 1st, 2010 to December 31st, 2017,
eleven NB patients were diagnosed with CNS relapse at our department.
All the eleven patients were classified to have high risk disease. The
median time from the completion of chemotherapy to CNS relapse was 5
months. Five patients did not receive any treatment for the relapsed
disease and finally died of it. Curative treatments were tried in six
patients. At last, two patients with isolated CNS relapsed NB survived.
Conclusions: The median time from the completion of chemotherapy to CNS
relapse is very short in the present retrospective study. It seems that
patients with isolated CNS relapsed disease have better outcomes. We
suggest the temozolomide-topotecan combination as an add-one backbone
for further salvage treatment in children with CNS relapsed NB, even
though this combination is not superior to others in terms of its
efficacy.