Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis

Abstract Metastatic neuroblastoma is a highly aggressive pediatric malignancy with poor prognosis. Radiotherapy is commonly used as part of multimodal treatment, but its impact on survival outcomes remains controversial. This study investigates the association between radiotherapy and survival in pa...

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Main Authors: Ailikamu Aierken, Falide Atabieke, Shui-Xue Li, Kai Li
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-99170-x
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author Ailikamu Aierken
Falide Atabieke
Shui-Xue Li
Kai Li
author_facet Ailikamu Aierken
Falide Atabieke
Shui-Xue Li
Kai Li
author_sort Ailikamu Aierken
collection DOAJ
description Abstract Metastatic neuroblastoma is a highly aggressive pediatric malignancy with poor prognosis. Radiotherapy is commonly used as part of multimodal treatment, but its impact on survival outcomes remains controversial. This study investigates the association between radiotherapy and survival in patients with metastatic neuroblastoma using data from the Surveillance, Epidemiology, and End Results (SEER) database. A retrospective analysis was conducted on 4,850 patients diagnosed with metastatic neuroblastoma from the SEER database (2004–2015). After applying exclusion criteria, 981 patients were included, with 368 receiving radiotherapy. Propensity score matching (PSM) was used to balance baseline characteristics between the radiotherapy and non-radiotherapy groups, resulting in 234 patients in each group. Survival outcomes were analyzed using Kaplan–Meier curves and Cox proportional hazards models. Before PSM, no significant difference in overall survival (OS) and cancer-specific survival (CSS) was observed between patients who received radiotherapy and those who did not. After PSM, there was a trend toward improved OS and CSS in the radiotherapy group, though statistical significance was not reached. Cox regression analysis identified age ≥ 1 year and non-adrenal primary tumor site as significant independent predictors of poorer OS and CSS. Radiotherapy was not an independent predictor of survival in the multivariate analysis, but a trend toward a survival benefit was noted, particularly in patients with larger tumors and those who underwent surgery. Radiotherapy may improve survival in metastatic neuroblastoma patients with large tumors or surgical resection, though its independent benefit remains uncertain. Personalized strategies require integrating updated COG risk stratification with biomarkers and prospective trials assessing long-term outcomes to refine treatment approaches.
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spelling doaj-art-764b8b3a5ed64e05a95fcd594a44f4f92025-08-20T02:55:31ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-99170-xImpact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysisAilikamu Aierken0Falide Atabieke1Shui-Xue Li2Kai Li3Department of General Surgery, Children’s Hospital of Xinjiang Uygur Autonomous RegionThe Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical UniversityDepartment of General Surgery, Children’s Hospital of Xinjiang Uygur Autonomous RegionDepartment of Urology, Children’s Hospital of Xinjiang Uygur Autonomous RegionAbstract Metastatic neuroblastoma is a highly aggressive pediatric malignancy with poor prognosis. Radiotherapy is commonly used as part of multimodal treatment, but its impact on survival outcomes remains controversial. This study investigates the association between radiotherapy and survival in patients with metastatic neuroblastoma using data from the Surveillance, Epidemiology, and End Results (SEER) database. A retrospective analysis was conducted on 4,850 patients diagnosed with metastatic neuroblastoma from the SEER database (2004–2015). After applying exclusion criteria, 981 patients were included, with 368 receiving radiotherapy. Propensity score matching (PSM) was used to balance baseline characteristics between the radiotherapy and non-radiotherapy groups, resulting in 234 patients in each group. Survival outcomes were analyzed using Kaplan–Meier curves and Cox proportional hazards models. Before PSM, no significant difference in overall survival (OS) and cancer-specific survival (CSS) was observed between patients who received radiotherapy and those who did not. After PSM, there was a trend toward improved OS and CSS in the radiotherapy group, though statistical significance was not reached. Cox regression analysis identified age ≥ 1 year and non-adrenal primary tumor site as significant independent predictors of poorer OS and CSS. Radiotherapy was not an independent predictor of survival in the multivariate analysis, but a trend toward a survival benefit was noted, particularly in patients with larger tumors and those who underwent surgery. Radiotherapy may improve survival in metastatic neuroblastoma patients with large tumors or surgical resection, though its independent benefit remains uncertain. Personalized strategies require integrating updated COG risk stratification with biomarkers and prospective trials assessing long-term outcomes to refine treatment approaches.https://doi.org/10.1038/s41598-025-99170-xMetastatic neuroblastomaRadiotherapySurvival analysisSEER databasePropensity score matchingCox regression analysis
spellingShingle Ailikamu Aierken
Falide Atabieke
Shui-Xue Li
Kai Li
Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis
Scientific Reports
Metastatic neuroblastoma
Radiotherapy
Survival analysis
SEER database
Propensity score matching
Cox regression analysis
title Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis
title_full Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis
title_fullStr Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis
title_full_unstemmed Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis
title_short Impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched SEER database analysis
title_sort impact of radiotherapy on survival outcomes in metastatic neuroblastoma a propensity score matched seer database analysis
topic Metastatic neuroblastoma
Radiotherapy
Survival analysis
SEER database
Propensity score matching
Cox regression analysis
url https://doi.org/10.1038/s41598-025-99170-x
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AT falideatabieke impactofradiotherapyonsurvivaloutcomesinmetastaticneuroblastomaapropensityscorematchedseerdatabaseanalysis
AT shuixueli impactofradiotherapyonsurvivaloutcomesinmetastaticneuroblastomaapropensityscorematchedseerdatabaseanalysis
AT kaili impactofradiotherapyonsurvivaloutcomesinmetastaticneuroblastomaapropensityscorematchedseerdatabaseanalysis