Related Experiment Videos
Treatment of stage IV-S neuroblastoma: a study of 34 cases treated between 1982 and 1987
A Suarez1, O Hartmann, G Vassal
1Department of Pediatrics, Institut Gustave Roussy, Villejuif, France.
Insights
Stage IV-S neuroblastoma in children can be managed with tailored treatments. Some patients achieve remission without intervention, while others require hepatic irradiation or chemotherapy, leading to a 75% disease-free survival rate.
Area of Science:
- Pediatric Oncology
- Cancer Research
- Clinical Medicine
Background:
- Neuroblastoma is a common childhood cancer.
- Stage IV-S neuroblastoma presents unique treatment challenges.
- Risk stratification is crucial for effective management.
Purpose of the Study:
- To evaluate the outcomes of stage IV-S neuroblastoma in children.
- To assess the effectiveness of different treatment strategies.
- To identify prognostic factors influencing survival.
Main Methods:
- Retrospective analysis of 34 stage IV-S neuroblastoma patients treated between 1982-1987.
- Classification into two groups based on clinical presentation: life-threatening symptoms vs. no life-threatening symptoms.
- Treatment modalities included hepatic irradiation, chemotherapy, and observation.
Main Results:
- Overall disease-free survival was 75% at 90 months.
- Patients with life-threatening symptoms (n=16) had a lower survival rate compared to those without (n=18).
- Hepatic irradiation and chemotherapy were employed in high-risk patients, while 25% of patients achieved remission without treatment.
Conclusions:
- A tailored therapeutic strategy for stage IV-S neuroblastoma can achieve favorable outcomes.
- Observation is a viable option for select patients.
- Early intervention with irradiation or chemotherapy improves survival in high-risk cases.
Abstract:
Between January 1982 and December 1987, of 283 children with neuroblastoma treated in the Pediatric Department of Institut Gustave Roussy, 34 were stage IV-S. Two groups were distinguished according to the initial clinical presentation: 16/34 patients had life-threatening symptoms and needed immediate treatment, and 18/34 had no life-threatening symptoms. Hepatic irradiation was used in 12/16 patients of the first group with respiratory distress. Chemotherapy was used in three patients. Of these 16 patients, three patients died of progressive disease (one patient died of a reason not related to the tumor). Twelve are alive in first complete remission and one in second complete remission. Of the 18 patients of the second group, eight had spontaneous complete remission, and one of them relapsed thereafter and died despite treatment. Ten patients needed treatment, radiotherapy, and/or chemotherapy depending on the site of disease progression. Two of them died of the disease. The overall disease-free survival for these 34 patients is 75% at 90 months postdiagnosis. Using this therapeutic strategy, it was possible to avoid any treatment of metastases in 25% of the patients.