[Intra-aortic prostaglandin E1 infusion in the treatment of advanced neuroblastoma]

Neuroblastoma, one of the commonest malignant childhood tumors, arises from the adrenal glands and/or sympathetic ganglia, and metastases into lymph nodes, bone marrow, bones, etc. Patients with advanced stages of neuroblastoma are poorly responsive to current combined chemo-radiotherapy. However, neuroblastoma is known to maturate into benign ganglioneuroma spontaneously or induced by certain chemicals. In our previous studies, adenosine 3', 5'-monophosphate (cAMP) was found to play an important role in this maturational process. It was also demonstrated that long-term continuous infusion of dibutyryl cAMP and papaverine caused significant growth-inhibition and tumor differentiation of C 1300 neuroblastoma in mice. These results prompted us to apply intra-aortic PGE1 infusion to two cases of abdominal neuroblastomas with stages III and IV.PGE1 infusion (0.25-3.0 ng/kg/min, over the period of 3 to 32 weeks), combined with oral papaverine and conventional chemotherapy, was effective in decreasing tumor size and promoting tumor maturation in the infused area. However, distant osseous metastases occurred in both cases, during and after the PGE1 administration. Similar modalities should be further evaluated in order to potentiate anti-metastatic effect on neuroblastoma cells.