Results of the NB-2015 Protocol for Treating Neuroblastoma in China: Experience From Multiple Centers

Background: The collaborative efforts of the Chinese Childhood Cancer Organization (CCCG) have led to an improved understanding of NB biology, standardized classification, and stratification strategies, thereby improving outcomes in China. We aimed to assess the NB-2015 protocol developed by the CCCG in 2015 and to evaluate the degree of impact of autologous peripheral blood stem cell transplantation (APBSCT). Methods: This study enrolled NB patients from seven medical centers in China between 2015 and 2018. In this paper, we retrospectively analyzed the clinical characteristics of 161 patients and used their effect on survival as an outcome measure. Results: The 3-year event-free survival (EFS) rates were 95.5%, 91.6%, and 51.1% in the low-, medium-, and high-risk groups, respectively. In total, 3 out of 7 (42.8%) patients with stage 2B disease, none of whom had MYCN amplifications, relapsed. A total of 47 of the 78 patients in the high-risk group underwent external-beam radiation to the primary tumor bed (dose ranging from 18 to 36 Gy). There was a significant difference in efficacy between patients who received radiation therapy and those who did not (3-year OS P = 0.041). Within the high-risk group, The 3-year EFS rates of the patients with and without APBSCT were 72.6% and 37.1%, respectively (P=0.008).Conclusions: This study showed that satisfactory results were obtained without fatal complications using the NB-2015 protocol. Chemotherapy should be intensified in the stage 2B group. APBSCT can effectively improve the survival rate of NB patients, especially high-risk patients.