RESULTS OF PEDIATRIC-ONCOLOGY-GROUP PROTOCOL-8104 FOR INFANTS WITH STAGES-D AND STAGE-DS NEUROBLASTOMA

Purpose: We determined the complete response and survival rates for in fants with disseminated (stage D) neuroblastoma that followed therapy identical to that for regional disease. In those infants whose disease excluded cortical bone metastases (stage DS), we determined complete response rates achieved either spontaneously or with stage D therapy. Patients and Methods: Eight-eight patients with metastatic disease rec eived induction chemotherapy followed by a second operation, the resul ts of which determined additional therapy. Twenty-five patients were o bserved after diagnosis, without chemotherapy, until a second operatio n. Results: The complete response (CR) rates for patients with stage D disease after induction chemotherapy and postinduction surgery were 2 6% and 52%, respectively, and for immediately treated patients with st age DS disease 69% and 77%, respectively. Fifty-four percent of initia lly observed patients with stage DS disease achieved CR after a second operation; 44% were never treated beyond these two operations. Five-y ear actuarial survival rates for patients with stage D and for all tho se with stage DS disease were 60% (SE = 6%) and 90% (SE = 5%), respect ively. Conclusions: Improved survival rates for patients with stage D disease were achieved on this protocol but remained considerably lower than those for infants with less extensive disease. Rates of survival for patients with stage DS disease were achieved with therapy less ag gressive than in published series.