Open AccessBrain metastasis in children with stage 4 neuroblastoma after multidisciplinary treatment
Author(s) -
Zhu Jia,
Wang Juan,
Zhen ZiJun,
Lu SuYing,
Zhang Fei,
Sun FeiFei,
Li PengFei,
Huang JunTing,
Cai RuiQing,
Sun XiaoFei
Publication year - 2015
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-015-0038-2
Subject(s) - brain metastasis , medicine , metastasis , neuroblastoma , stage (stratigraphy) , oncology , incidence (geometry) , cancer , biology , paleontology , physics , optics , genetics , cell culture
Brain metastasis is common in relapsed neuroblastoma patients, but the characteristics of brain metastasis remain largely unknown. This study aimed to investigate the status of brain metastasis with neuroblastoma in South China. Methods In this retrospective case‐based study, 106 patients with stage 4 neuroblastoma from the Department of Pediatric Oncology in Sun Yat‐sen University Cancer Center between January 2004 and May 2013 were included. The incidence, risk factors, and survival status of these patients were reviewed and analyzed. Results Of the 106 patients, 11 (10.4%) developed brain metastasis, accounting for 20.0% of 55 patients with relapse or progression. The age at initial diagnosis of the 11 patients ranged from 2 to 10 years (median 4 years), which was younger than that of the patients without brain metastasis (median 5 years, range 1–10 years, P = 0.073). The male to female ratio of the 11 patients was 8:3, which was not significantly different from that of the patients without brain metastasis ( P = 0.86). Patients with brain metastasis had higher lactate dehydrogenase levels than those without brain metastasis, but the differences were not significant ( P = 0.076). Eight patients died, and 3 patients survived. The median interval from the initial diagnosis to the development of brain metastasis was 18 months (range 6–32 months). The median survival was 4 months (range 1 day to 29 months) after the diagnosis of brain metastasis. The median interval from the manifestation of brain metastasis to death was 3 months (range 1 day to 11 months). Conclusions High‐risk factors for brain metastasis in cases of neuroblastoma include bone marrow involvement and a younger age at initial diagnosis. Nevertheless, multiple treatment modalities can improve disease‐free survival.