[A preliminary treatment report of the Study Group of Japan for Advanced Neuroblastoma]

We present preliminary treatment results of a nation-wide cooperative clinical study for advanced neuroblastoma supported by a grant-in-aid for cancer research from the Japanese Ministry of Health and Welfare. This study involves 28 major pediatric oncology institutions in Japan and started in May, 1985. Until 1987 we treated 84 patients with stage III and IV neuroblastoma whose prognosis was considered to be extremely poor. Every patient who entered this study received 6 cycles of A1 protocol consisted of high dose cyclophosphamide, vincristine, cis-platinum and THP-adriamycin, a newly introduced low-cardiotoxic anthracycline derivative. Having received 6 cycles of A1 protocol, patients were divided into 3 groups, i.e., ACNU course, DTIC course and bone marrow transplantation course preconditioned by high dose melphalan. Of 77 patients who received more than 3 cycles of A1 protocol, tumor extirpation was performed in 69 patients. Total or subtotal resection of the original tumor and the regional lymph-nodes was possible in 57 cases. The high resectability of the tumor indicates marked effectiveness of this protocol. Of the 57 patients who followed this treatment protocol from the beginning (virgin case), 31 (54.4%) showed complete response and 26 still remains in complete remission. 93.0% of response rate (CR + PR) was obtained by the treatment protocols, which was considerably high as compared with the results of other treatment protocol reported. This protocol also worked well in the patients who had failed with other treatment protocol.(ABSTRACT TRUNCATED AT 250 WORDS)