肿瘤细胞治疗研究
英文原题：Therapeutic Innovation in Pediatric Neuroblastoma: Age and Stage-Specific Strategies from Prenatal to Early Childhood-A Review Article.
治疗的进步带来了希望，但在这类复杂的儿童恶性肿瘤中，实现持久缓解和改善生存仍需要深入的研究创新，以解决当前的空白和耐药机制。
神经母细胞瘤是最常见的儿童癌症之一，主要影响幼儿。尽管初始治疗已有进展，高危病例仍因频繁复发或耐药而难以治疗；复发或难治性神经母细胞瘤的长期生存率低于 20%，凸显了开发新疗法的迫切需求。新兴治疗方法显示出希望，包括 GD2 靶向单克隆抗体免疫治疗（如 dinutuximab）、CAR-T 细胞疗法、¹³¹I-MIBG 和镥-177-Dotatate 放射性核素治疗、节拍化疗、溶瘤病毒治疗及个体化化疗；自体造血干细胞移植（ASCT）也已成为多模式治疗的重要组成部分。但治疗相关毒性、肿瘤耐药及个体化医疗的实施限制仍未解决。未来可利用基因组分析、生物标志物，并采用免疫治疗联合放射性核素治疗等组合策略。严格的临床试验对于优化这些创新疗法并建立广泛应用方案至关重要。总之，治疗进步带来了希望，但要实现持久缓解和提高生存率，仍需深入研究，以弥补现有不足并解决这一复杂儿童恶性肿瘤的耐药机制。
Neuroblastoma is one of the most common pediatric cancers, predominantly affecting young children. Despite progress in initial treatments, high-risk cases remain challenging due to frequent relapse or resistance, with long-term survival for relapsed or refractory neuroblastoma below 20%. This highlights an urgent need for novel therapies. Emerging approaches such as GD2-targeted immunotherapy with monoclonal antibodies like dinutuximab, CAR-T cell therapy, 131I-MIBG and Lutetium-177-Dotatate radionuclide treatments, metronomic chemotherapy, oncolytic virotherapy, and tailored chemotherapy are showing promise, with autologous stem cell transplantation (ASCT) becoming integral to multimodal regimens. However, challenges persist, including treatment-related toxicity, tumor resistance, and the logistical limitations of personalized medicine. The future of neuroblastoma treatment lies in exploiting genomic profiling, biomarkers, and combinatorial strategies like immunotherapy paired with radionuclide therapy. Rigorous clinical trials will be key to refining these innovations and establishing protocols for widespread use. In summary, advancements in therapy offer hope, yet achieving durable remissions and improved survival still demands intensive research innovation to address current gaps and resistance mechanisms in this complex pediatric malignancy.
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