Palliative Approach in Neuroblastoma: A Retrospective Study in the 3rd Pediatric Clinic of “Louis Turcanu” Children’s Hospital - EAP 2019 Congress and MasterCourse Porto Palacio Hotel

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¹Pediatrics, University of Medicine and Pharmacy "V. Babes'', Romania
²Hemato-Oncology, III-rd Pediatric Clinic, Emergency Hospital for Children Louis Turcanu, Romania
³Nephrology, III-rd Pediatric Clinic, Emergency Hospital for Children Louis Turcanu, Romania
⁴Palliative Care, III-rd Pediatric Clinic, Emergency Hospital for Children Louis Turcanu, Romania
⁵Humanmedizin, Ludwig Maximillian Universitat, Germany

Neuroblastoma (NB) is an important cause of cancer in childen.The survival rate has increased in the last decade due to improved diagnostic accuracy and therapeutic approach.

Objectives:A retrospective analysis of NB cases admitted in our clinic during 2000–2018 has been performed to highlight the importance of palliative approach from diagnosis,due to the rapid progression of the disease and its high mortality.

Material:The study group consisted of 48 patients , aged 1 month to 15 years, 25 girl (52.08%) and 23 boys (47.92%), 41.66% from a rural area, 58.33% with urban background.

Method:The study group was analyzed by clinical criteria and laboratory data, allowing diagnosis and staging.Data were statistically analyzed.The need for a holistic approach was recognized from the start and applied throughout the treatment.

Results:18.75% were < 1 year at onset, 31.25% aged 1-3 years,14.58% 3-6 years and 35.41% >6 years.The disease’s onset was: 50% abdominal, 25% mediastinal ,intrathoracic 8.33%, paravertebral 4.16%, 2.08% sacrococcygeal and 2,08% in the jaw. Metastases were present in 50% of NB cases with abdominal onset,25% of the patients with thoracic onset,50% in those with paravertebral onset, and a 100% by sacrococcygeal diagnosis.The histopathological exam results were:75% were neuroblastoma,20.8% ganglioneuroblastoma,4.16% other types of NB. Evolution within a year after chemotherapy was favorable in 64.58%,22,91% died and for 12,5% there is no data. Progress after 3 years was positive in 45.8%, 41,66% of the cases died .In all cases psychological and spiritual support was provided for the family and patient by a multidisciplinary team.2 received bone marrow transplant.

Conclusions: NB is a malignant tumor with favorable evolution in less than half of the patients . At the onset >50% were in advanced stages, which explains the poor outcome.Due to the unfavorable outcome and the rapid progression patients and their families profit by a palliative approach implemented from onset.