Localised and unresectable neuroblastoma in infants: Excellent outcome with primary chemotherapy

Procedure. infants with neuroblastoma (NB) were assessed according to INSS recommendations, including MIBG scan and extensive bone marrow staging to e liminate metastatic spread. Patients with unresectable tumour received chem otherapy, including two courses of carboplatin-etoposide (CE) and two of vi ncristine-cyclophosphamide-doxorubicin (CAdO). Postoperative treatment was to be given only in infants with MYCN amplification. Between 1990 and 1994, 52 consecutive children were registered. Results. Among the 44 patients wh o received CE as a first course, the response rate was 66% and the primary could be removed in children but one, who was in remission. The toxicity wa s mainly haematological and was always manageable. The 5 year overall survi val (OS) and event-free survival (EFS) were 94 and 90 +/- 8%, respectively, with a median follow-up of 48 months. The outcome of infants with no MYCN amplification was excellent; OS and EFS were, respectively, 97 and 94%. Con clusions. Chemotherapy allows surgical excision and excellent outcome in in fants with localised and unresectable NE. Less intensive Chemotherapy shoul d be investigated in such patients. Med. Pediatr. Oncol. 36:247-250, 2001. (C) 2001 Wiley-Liss, Inc.