Abstract OBJECTIVE: To evaluate the effects and the toxicity of the protocol of CDV combined with CiE as pre-operative chemotherapy in childhood stage IV neuroblastoma. METHODS: The clinical data of 27 children aged from 1.2 to 8 years with neuroblastoma in stage IV was retrospectively studied. The primary sites of the diseases were abdomen (n=21), posterior mediastinum (n=4) and pelvic cavity (n=2). Twenty-three patients had bone marrow metastasis. Twelve patients had bone metastasis. All patients were treated with the CDV protocol (cyclophosphamide+doxorubicin+vincristine) for 3 cycles and the CiE protocol (cisplatin+etoposide) for 2 cycles. Neuroblastoma therapeutic response evaluation criterion and common terminology criteria for adverse events of National Cancer Institute were used to evaluate effects and chemotherapy-related toxicity. RESULTS: All patients received the pre-operative chemotherapy. The overall response rate was 82%. After chemotherapy, 24 patients received operations. Total resection of primary tumor was found in 14 patients (58%) and part resection in 10 patients (42%). The most common chemotherapy-related toxicity was bone marrow suppression: grade IV suppression of neutrophils (n=27), reduction in hemoglobin (III grade, n=7; IV grade, n=20) and reduction in platelet (III grade, n=2; IV grade, n=25). Infection was found in all patients and was controlled with antibiotics.I or II grade lesions of digestive, liver and kidney were found and could be recovered after therapy. Grade I neurotoxicity occurred in 2 patients (7%). The heart function damage was not found in any of patients. CONCLUSIONS: The protocol of CDV combined with CiE as pre-operative chemotherapy might be effective in children with stage IVneuroblastoma.[Chin J Contemp Pediatr, 2009, 11 (11):885-887]
FENG Chen,TANG Suo-Qin,WANG Jian-Wen et al. Curative effects of the protocol of CDV combined with CiE as pre-operative chemotherapy in high-risk childhood neuroblastoma[J]. 中国当代儿科杂志, 2009, 11(12): 885-887.
FENG Chen,TANG Suo-Qin,WANG Jian-Wen et al. Curative effects of the protocol of CDV combined with CiE as pre-operative chemotherapy in high-risk childhood neuroblastoma[J]. CJCP, 2009, 11(12): 885-887.
[1]Schwab M, Westermann F, Hero B, Berthold F. Neuroblastoma: biology and molecular and chromosomal pathology[J]. Lancet Oncol, 2003, 4(8):472-480.
[2]Castel V, Tovar JA, Costa E, Cuadros J, Ruiz A, Rollan V, et al. The role of surgery in stage IV neuroblastoma [J]. J Pediatr Surg, 2002, 37(11):1574-1578.
[5]Kushner BH, Kramer K, LaQuaglia MP, Modak S, Yataghene K, Cheung NK. Reduction from seven to five cycles of intensive induction chemotherapy in children with high-risk neuroblastoma[J]. J Clin Oncol, 2004, 22(24):4888-4892.
[6]McWilliams NB, Hayes FA, Green AA, Smith EI, Nitschke R, Altshuler GA, et al. Cyclophosphamide/doxorubicin vs. cisplatin/teniposide in the treatment of children older than 12 months of age with disseminated neuroblastoma:a Pediatric Oncology Group Randomized Phase II study[J]. Med Pediatr Oncol, 1995, 24(3):176-180.