细胞分裂与细胞周期及答案.ppt

* * * * * * * * * * Figure 3.?(A) Scintigraphy at initial 131I-MIBG treatment showing extensive bone metastases of neuroblastoma. (B) After treatment with three 131I-MIBG cycles (cumulative dose: 400 mCi) and hyperbaryc oxygen a significant reduction in tumor sites is observed. Neuroblastoma Introduction. Neuroblastoma is a solid tumor of childhood that arises in the nervous system outside of the brain. Children who have aggressive neuroblastomas are at high-risk for having the tumor recur and or grow out of control (progress) if given standard (low-dose) chemotherapy. These patients are classified as having high-risk neuroblastoma. This portion of the NANT web site briefly reviews the initial treatment options available for children with high-risk neuroblastoma. We also present some of the new approaches to treating patients with high-risk neuroblastoma whose tumors have progressed or recurred. What is high-risk neuroblastoma? The clinical behavior of neuroblastoma is highly variable, with some tumors being easily treatable, but approximately 50% of the tumors are very aggressive. This brief summary only addresses therapy of high-risk neuroblastoma. The treatment of low or intermediate risk tumors is very different from treating high-risk disease. The staging system (by degree of tumor spread) for neuroblastoma is shown below. All patients with stage 4 disease diagnosed after 18 months of age are in the high-risk category. In stage 4 disease, the neuroblastoma tumor cells have already spread (metastasized) to other sites in the body such as the bone or bone marrow. Additionally, essentially all patients who have tumors with many copies (gene amplification) of the MYCN cancer gene also have high-risk disease, even if they do not have evidence of the tumor having spread. It is accepted practice to treat high-risk neuroblastoma patients with intensive therapy (including stem cell transplant) because these patients are at high risk of not surviving their disease unles