Neuroblastoma between 1990 and 2014 in the Netherlands: Increased incidence and improved survival of high-risk neuroblastoma.

PURPOSE: Long-term trends in neuroblastoma incidence and survival in unscreened populations are unknown. We explored trends in incidence, stage at diagnosis, treatment and survival of neuroblastoma in the Netherlands from 1990 to 2014. METHODS: The Netherlands Cancer Registry provided data on all patients aged <18 years diagnosed with a neuroblastoma. Trends in incidence and stage were evaluated by calculating the average annual percentage change (AAPC). Univariate and multivariable survival analyses were performed for stage 4 disease to test whether changes in treatment are associated with survival. RESULTS: Of the 593 newly diagnosed neuroblastoma cases, 45% was <18 months of age at diagnosis and 52% had stage 4 disease. The age-standardized incidence rate for stage 4 disease increased at all ages from 3.2 to 5.3 per million children per year (AAPC + 2.9%, p < .01). This increase was solely for patients ≥18 months old (3.0-5.4; AAPC +3.3%, p = .01). Five-year OS of all patients increased from 44 ± 5% to 61 ± 4% from 1990 to 2014 (p < .01) and from 19 ± 6% to 44 ± 6% (p < .01) for patients with stage 4 disease. Multivariable analysis revealed that high-dose chemotherapy followed by autologous stem cell rescue and anti-GD2-based immunotherapy were associated with this survival increase (HR 0.46, p < .01 and HR 0.37, p < .01, respectively). CONCLUSION: Incidence of stage 4 neuroblastoma increased exclusively in patients aged ≥18 months since 1990, whereas the incidence of other stages remained stable. The 5-year OS of stage 4 patients improved, mostly due to the introduction of high-dose chemotherapy followed by stem cell rescue and immunotherapy.

The effect of hyperbaric oxygen therapy on quality of life in oral and oropharyngeal cancer patients treated with radiotherapy.

Radiotherapy is used in the setting of curative treatment for head and neck cancer. Xerostomia and related problems occur when major salivary glands are included in the irradiation fields. This reduces quality of life (QOL). Hyperbaric oxygen therapy (HBOT) is a well accepted treatment or prevention modality for osteoradionecrosis of the jawbones and soft-tissue necrosis. It is unknown if and to what extent HBOT influences xerostomia and xerostomia-related QOL. To address this, a prospective study was conducted. Twenty-one patients who underwent radiotherapy for an oral or oropharyngeal carcinoma completed a European Organization for Research and Treatment of Cancer QOL questionnaire before HBOT, as part of the treatment/prevention of osteoradionecrosis, and 1 and 2 years after HBOT. Swallowing-related problems significantly decreased in time, and there was a reported subjective increase in saliva quantity and an improvement in sense of taste. The results suggest that HBOT may positively influence these long-term radiotherapy sequelae.