A Combined Chemotherapy for the Advanced Neuroblastoma (I) : Group Study in Kyushu Area

Abstract

The prognosis of the advanced neuroblastoma still remains very poor in spite of the recent advances in the therapies of children's cancers. For the purpose of improving the prognosis, we organized a chemotherapeutic group study to treat patients with Stage III and IV (exceptIV-S) neuroblastoma in Kyushu area in Japan, which started in March 1982. The protocol was divided into A and B, and was scheduled as follows : Protocol-A ; 3courses of cyc lophosphamide (CPA,40 mg/kg×2 days) was given every 3 weeks and then 3courses of cisplatin (CDDP,20 mg/m^2×5 days)+VM-26 (100mg/m^2,after 48 hrs) were sequentially administered, protocol-B ; the same dose of CPA and the same doses CDDP+VM-26 were given alternately every 3 weeks. Until March, 1984, 19 cases were registered, among whom 15 were evaluated. The therapeutic results are as follows : Protocol-A ; 3 of 6 cases are alive, Protocol-B ; all of 6 cases are alive (5 more than 12 months). Three were recurrent, all of whom died. These preliminary results suggested that the combined high dose chemotherapy such as Protocol-B using CPA, CDDP and VM-26 were much more effective for the advanced neuroblastema. The side effects especially of CDDP are also discussed.