Analysis of curative effect of the NB09 protocol based on 95 children with stage 4 neuroblastomas

Objective To assess the outcomes of stage 4 neuroblastomas (NB), and analyze the associated prognostic factors. Methods Ninety-five children with stage 4 NB were retrospectively analyzed. The curative effects and related fac- tors affecting prognosis were compared between NB09 protocol group (n=40) and non-NB09 group (n=55). The median age of 95 children was 48 months (4-136 months), and the median follow-up time was 21 months (4-179 months). Results The total survival rate and progression free survival rate were significantly better in NB09 group than those of non-NB09 group (χ 2 =6.916 and 0.025,P 20%, N-MYC amplification, surgical extent 1 000 U/L and very good partial remission (VGPR) were the influencing factors for the prognosis in children (P 20% was the bad independent prognostic factors for stage 4 patients. Conclu- sion Children with stage 4 NB treated according to the NB09 protocol have a better prognosis. Children of stage 4 neuro- blastomas with bone marrow involvement >20% have a bad prognosis to current treatment.