DOES MEGATHERAPY CONTRIBUTE TO SURVIVAL IN METASTATIC NEUROBLASTOMA -A RETROSPECTIVE ANALYSIS

To evaluate the impact of megatherapy on the outcome of high risk neur oblastoma, 39 patients with stage IV neuroblastoma, who underwent mega therapy, were analyzed retrospectively and compared to 49 patients. wh o continued chemotherapy according to the German cooperative trial NB8 5. The groups were comparable concerning age, primary localisation, pa ttern of metastases, clinical risk groups and response to induction th erapy. Overall survival of the megatherapy group was 0.23 +/- 0.07 a c ompared to 0.14 +/- 0.05 of the chemotherapy group (p = 0.0149). In pa rticular patients with partial response to induction chemotherapy appe ared to gain from megatherapy, while patients in complete remission di d not benefit. Subset analysis confirmed the superiority of megatherap y in patients with bone marrow Infiltration at diagnosis, in patients with or without bone metastases at diagnosis and in patients older tha n 2 years. On the background of the poor prognosis of stage 4 neurobla stoma and lack of other effective treatment modalities these data supp ort the utilization of megatherapy in treatment strategies far stage I V neuroblastoma.