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Stage IV neuroblastoma in infants. Long-term survival
S R Paul1, N J Tarbell, B Korf
1Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02115.
Insights
Intensive multiagent chemotherapy significantly improves outcomes for infants with Stage IV neuroblastoma. This study shows a 75% event-free survival rate, offering hope for young cancer patients.
Area of Science:
- Pediatric Oncology
- Cancer Therapeutics
- Neuroblastoma Research
Background:
- Stage IV neuroblastoma historically had a poor prognosis across all age groups.
- Recent advancements show improved outcomes specifically for infants with Stage IV neuroblastoma.
- Multiagent chemotherapy has emerged as a key treatment modality.
Purpose of the Study:
- To update the outcomes of infants with Stage IV neuroblastoma treated with intensive chemotherapy.
- To evaluate the long-term event-free survival in this patient cohort.
- To assess the impact of bone metastases on prognosis in infants.
Main Methods:
- Retrospective analysis of 24 infants diagnosed with Stage IV neuroblastoma between 1970 and 1988.
- Treatment involved intensive multiagent chemotherapy for most patients.
- Data collection focused on event-free survival and presence of bone metastases.
Main Results:
- A 5-year actuarial event-free survival rate of 75% was achieved for the 24 infants.
- No patients without bone metastases died from neuroblastoma.
- 12 out of 16 patients with bone metastases remained disease-free.
Conclusions:
- Intensive multiagent chemotherapy offers a very good prognosis for infants with Stage IV neuroblastoma.
- The presence of bone metastases does not preclude a favorable outcome in this age group.
- This treatment approach represents a significant advancement in pediatric neuroblastoma care.
Abstract:
Before the advent of multiagent chemotherapy, the prognosis for patients with Stage IV neuroblastoma of all ages was dismal. More recently, marked improvement in infants with Stage IV neuroblastoma has been reported. Twenty-four infants with Stage IV neuroblastoma have been treated at the Dana-Farber Cancer Institute/The Children's Hospital, and the Joint Center For Radiation Therapy, Boston, Massachusetts, between 1970 and 1988. Twenty-three of these patients were treated with multiagent chemotherapy and one with a single drug. In the initial report, ten of 11 patients were alive without evidence of disease after intensive therapy. In this report the authors update their initial series of patients and include 13 additional patients who subsequently presented to our institutions with Stage IV neuroblastoma younger than 1 year of age. The 5-year actuarial event-free survival for the 24 patients is 75%. No patient without bone metastases died from neuroblastoma, and 12 of 16 patients with bone metastases remained disease free. These results confirm that infants with Stage IV neuroblastoma have a very good prognosis when treated with intensive multiagent chemotherapy.