Intensive chemotherapy in children with stage IV neuroblastoma

Abstract

A retrospective analysis of effectiveness of sequential chemotherapy with cyclophosphamide, doxorubicin, cisplatin and etoposide in children with stage IV neuroblastoma was undertaken. Study group included 17 children of mores than one year old with median age of 3 years (range 18 months to 7 years). Fourteen were males and three females. Sites of primary tumor were abdomen in 12 patients, pelvis in 3, paravertebral in 1 and unknown in 1. Metastatic sites included bone marrow (88%), bone (82%), orbit (29.4%) and lymph node (11.7%). One patient had brain parenchymal disease and another had cerebrospinal fluid positivity for malignant cells. Fifteen of the 17 patients had major response with chemotherapy (complete response in two and partial response in 13). Ten of the 15 patients completed four courses of chemotherapy and five patients progressed while on chemotherapy and died. Only two of the ten patients, who had four courses chemotherapy are alive after 2 years. Hence the 2-year survival in this series is 11.7%. There was no toxic death in this study.

Neuroblastic Tumours in Children

“…There is a paucity of literature on the outcome of children with neuroblastic tumours from a developing country like India and also the available literature is not uniform. [ 5 6 7 8 9 10 11 ] Lack of awareness, illiteracy, low socioeconomic status and relatively less referral centres are associated with late presentation, poor outcome and high dropout rate. [ 5 6 7 8 9 10 11 ] The aim of this study is to present our experience with neuroblastic tumours and their outcome in the patients treated at our centre.…”

“…[ 5 6 7 8 9 10 11 ] Lack of awareness, illiteracy, low socioeconomic status and relatively less referral centres are associated with late presentation, poor outcome and high dropout rate. [ 5 6 7 8 9 10 11 ] The aim of this study is to present our experience with neuroblastic tumours and their outcome in the patients treated at our centre.…”

Pediatric neuroblastoma - Impact of nutritional status on complications and outcomes

“…Very few centers in India have studied and published the outcomes and prognostic factors. [ 3 4 5 6 7 ] The factors contributing to poor outcome in India are late presentation, poor nutrition status, poor compliance to treatment, cost, and nonavailability of autologous stem cell transplantation at most centers. [ 8 ] Good nutritional status is always warranted; however, the effect of poor nutritional status has not been evaluated by most of the studies.…”

Autologous stem cell transplant for high‐risk neuroblastoma: Achieving cure with low‐cost adaptations

“…Several (72%) patients with stage IV neuroblastoma could not proceed to ASCT due to nonavailability and lengthy waiting time 12 . Cure rates from India have been reported in the range of 10‐34%, with a limited number of patients undergoing ASCT 13‐16 …”

“…12 Cure rates from India have been reported in the range of 10-34%, with a limited number of patients undergoing ASCT. [13][14][15][16] Due to the multidisciplinary treatment, visits to several departments are typically required for patients of HR-NB. This may be another factor in reducing compliance in LMIC as it is challenging to attend outpatient services of different departments, distributed across the campus of the hospital complex.…”