Local control with multimodality therapy for stage 4 neuroblastoma Journal Article
| Authors: | Wolden, S. L.; Gollamudi, S. V.; Kushner, B. H.; Laquaglia, M.; Kramer, K.; Rosen, N.; Abramson, S.; Cheung, N. K. V. |
| Article Title: | Local control with multimodality therapy for stage 4 neuroblastoma |
| Abstract: | Purpose: To evaluate the efficacy of 21 Gy hyperfractionated radiotherapy for local control in conjunction with surgery and intensive systemic therapy for patients with Stage 4 neuroblastoma. Methods and Materials: After achieving a partial or complete remission, 47 children, ages 1-10 years, with Stage 4 neuroblastoma were treated on four consecutive institutional protocols (N4-N7) with dose-intensive multi-agent chemotherapy, maximal surgical debulking, and hyperfractionated radiotherapy (1.5 Gy twice a day to 21 Gy). Radiotherapy fields encompassed the initial tumor volume and regional lymph nodes plus a 3-cm margin. This was followed by consolidation with either autologous bone marrow transplantation (N4 and N5) or immunotherapy (N6 and N7). Results: Forty-five of 47 patients had a complete response to surgery and chemotherapy prior to radiotherapy. Five-year actuarial rates of local control, progression-free survival, and overall survival were 84%, 40%, and 45%, respectively. Among 26 patients who relapsed, 1 failed only at the primary site, 22 developed distant metastases exclusively, and 3 had both local and distant failures. There were no acute complications of radiotherapy. Conclusion: Hyperfractionated radiotherapy to 21 Gy, in conjunction with dose-intensive systemic therapy and aggressive surgical resection, is well tolerated and is associated with durable local control for most patients with Stage 4 neuroblastoma. Copyright (C) 2000 Elsevier Science Inc. |
| Keywords: | cancer chemotherapy; cancer survival; child; clinical article; controlled study; preschool child; school child; disease-free survival; clinical trial; cisplatin; doxorubicin; multimodality cancer therapy; combined modality therapy; cancer staging; follow-up studies; neoplasm staging; controlled clinical trial; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; radiotherapy; relapse; cyclophosphamide; infant; neuroblastoma; minimal residual disease; neoplasm, residual; local control; dose fractionation; autologous bone marrow transplantation; humans; human; male; female; priority journal; article; hyperfractionation |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 46 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2000-03-01 |
| Start Page: | 969 |
| End Page: | 974 |
| Language: | English |
| DOI: | 10.1016/s0360-3016(99)00399-5 |
| PUBMED: | 10705019 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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