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目的研究CDV和CiE方案治疗晚期神经母细胞瘤的短期疗效及患儿耐受性。方法选择IV期神经母细胞瘤6例,年龄4～7岁。诱导方案CDV4疗程,CiE2疗程。用药:Ⅴ:长春新碱0.67mg/(m2·24h),第1、2、3天,持续滴注72h;D:柔红霉素:25mg/(m2·24h),第1、2、3天,持续72h;C:环磷酰胺2.1g/(m2·24h),第1、2天,持续滴注48h;Ci:顺铂50mg/(m2·24h),持续1h,第1、2、3天;E:足叶乙甙200mg/(m2·24h),持续2h,第1、2、3天。结果6例转移病灶全部消失,包括骨髓、骨组织、眼球后。化疗后白细胞降低明显,至(0.1～0.2)×109/L,3～4周恢复至3×109/L,每例患儿在化疗不同疗程中出现38°C～39°C的发热1～2次,持续3～8d。2例血培养大肠杆菌阳性各1次,CRP升高分别为25mg/L、32mg/L,其余血培养阴性,用亚胺培等感染控制。结论晚期神经母细胞瘤可较好的耐受CDV和CiE强烈诱导化疗,近期疗效较好。
Objective To study the short-term efficacy and tolerability of CDV and CiE regimens in the treatment of advanced neuroblastoma. Methods Six cases of stage IV neuroblastoma were selected, aged 4 to 7 years old. Induction program CDV4 treatment, CiE2 treatment. Drugs: Ⅴ: Vincristin 0.67mg / (m2 · 24h), on the first and second days of continuous infusion 72h; D: daunorubicin: 25mg / (m2 · 24h), 1,2,3 Day for 72h; C: cyclophosphamide 2.1g / (m2 · 24h), on the first and second days, continuous infusion of 48h; Ci: cisplatin 50mg / (m2 · 24h) for 1h, 3 days; E: Etoposide 200mg / (m2 · 24h) for 2h, days 1, 2, 3. Results All 6 cases of metastatic lesions disappeared, including bone marrow, bone tissue and retrobulbar eyes. Chemotherapy after leukopenia significantly reduced to (0.1-0.2) × 109 / L, 3 to 4 weeks returned to 3 × 109 / L, each case of children in different courses of chemotherapy 38 ° C ~ 39 ° C fever 1 ~ 2 times for 3 ~ 8d. 2 cases of blood culture Escherichia coli positive 1 times, CRP increased were 25mg / L, 32mg / L, the remaining blood culture negative with imipenem and other infection control. Conclusion Advanced neuroblastoma can tolerate CDV and CiE strongly induced chemotherapy, the recent curative effect is better.