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Intensive chemotherapy in children with stage IV neuroblastoma

P Kusumakumari1, T V Ajithkumar, S Hariharan

  • 1Division of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala. rcctvm@md2.vsnl.net.in

Indian Journal of Pediatrics
|May 8, 2000
PubMed

Insights

Sequential chemotherapy using cyclophosphamide, doxorubicin, cisplatin, and etoposide showed limited 2-year survival (11.7%) in children with stage IV neuroblastoma, despite initial major response rates. No toxic deaths were observed.

Area of Science:

  • Pediatric Oncology
  • Medical Chemotherapy
  • Neuroblastoma Research

Background:

  • Stage IV neuroblastoma presents a significant challenge in pediatric oncology.
  • Effective treatment strategies for advanced neuroblastoma are crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of sequential chemotherapy with cyclophosphamide, doxorubicin, cisplatin, and etoposide in children with stage IV neuroblastoma.
  • To determine the overall survival rates and treatment toxicities associated with this chemotherapy regimen.

Main Methods:

  • Retrospective analysis of 17 children diagnosed with stage IV neuroblastoma.
  • Treatment involved sequential chemotherapy with cyclophosphamide, doxorubicin, cisplatin, and etoposide.
  • Patient data included age, sex, primary tumor site, metastatic sites, treatment response, and survival.

Main Results:

  • Fifteen of 17 patients (88%) achieved a major response (2 complete, 13 partial) to chemotherapy.
  • Only 2 of 10 patients who completed four chemotherapy courses survived beyond 2 years, resulting in an 11.7% 2-year survival rate.
  • Common metastatic sites included bone marrow (88%) and bone (82%).

Conclusions:

  • Sequential chemotherapy with cyclophosphamide, doxorubicin, cisplatin, and etoposide demonstrates limited long-term efficacy in stage IV neuroblastoma.
  • While achieving initial responses, the regimen did not translate to significantly improved 2-year survival rates.
  • The regimen was well-tolerated, with no reported toxic deaths, suggesting potential for combination with other therapeutic approaches.

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