The treatment of neuroblastoma with intraspinal extension with chemotherapy followed by surgical removal of residual disease: A prospective study of 42 patients--Results of the NBL 90 study of the French Society of Pediatric Oncology

Plantaz, Dominique; Rubie, H; Michon, Jean; Méchinaud, Françoise; Coze, Carole; Chastagner, Pascal; Frappaz, Didier; Gigaud, M.; Passagia, J.-G.; Hartmann, Olivier

doi:10.1002/(sici)1097-0142(19960715)78:2<311::aid-cncr19>3.0.co;2-z

Cited by 102 publications

(63 citation statements)

References 25 publications

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“…Positive MIBG uptake of the primary and elevated biological markers were more frequent in those tumours as well as NMA. Dumbbell tumours were found in 34 children, of whom 27 had a neurological deficit and are described more precisely elsewhere (Plantaz et al, 1996).…”

Section: Resultsmentioning

confidence: 99%

“…Although the incidence of persistent macroscopic residual disease was still higher than in resectable NBs, the EFS rate of those children was still good (75% vs 85%). Moreover, this chemotherapy combination appears appropriate in dumbbell tumours as neurological recovery was observed in 90% of cases without laminectomy (Plantaz et al, 1996). Amazingly, response to chemotherapy was not predictive of subsequent outcome.…”

Section: Discussionmentioning

confidence: 97%

“…Consequently, the overall response rate (RR) was 71%, regardless of the type of chemotherapy. Dumbbell tumours responded as well as other primaries (Plantaz et al, 1996). Finally, all but five of the children underwent surgery: one died early, three had progressive disease and died of the disease and one was in CR according to imaging data.…”

Section: Primary Chemotherapymentioning

confidence: 95%

“…Eight patients developed severe sequelae (neurological and/or orthopaedic), all arising in dumbbell tumours exhibiting symptoms (Plantaz et al, 1996). One child developed major acute renal failure after secondary surgery, leading to kidney transplantation, and is still 80.: alive in remission.…”

Section: Outcomementioning

confidence: 99%

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Unresectable localized neuroblastoma: improved survival after primary chemotherapy including carboplatin-etoposide

Michon¹,

Plantaz²,

Peyroulet³

et al. 1998

Br J Cancer

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Keywords: neuroblastoma; carboplatin; etoposide; N-myc Neuroblastoma (NB) is the most common solid tumour of early childhood (Bernstein et al, 1992). Approximately 50% of patients present with localized tumours (Hartmann et al, 1983;Rosen et al, 1984a) and radical surgical excision is generally considered as the main requirement for cure (Evans et al, 1976; Le Toumeau et al, 1985). Primary surgery can be performed in about half of these children and reported survival rates are high (De Bernardi et al, 1995). However, unresectable tumours usually have a poorer outcome, unless secondary radical excision can be performed (Rosen et al, 1984b;Haase et al, 1989;Tsuchida et al, 1992). Consequently, the efficacy of primary chemotherapy to allow subsequent resection is of outstanding importance (Garaventa et al, 1993; West et al, 1993). We previously reported the efficacy of the combination of carboplatin and etoposide (CE) in refractory or relapsed NBs (Frappaz et al, 1992) and investigated its relevance as a first line therapy in unresectable NBs.In 1990, a national prospective study (NBL 90) was initiated, registering all children with localized NBs diagnosed in the institutions of the French Society of Pediatric Oncology (SFOP). The Primary aim was to assess the efficacy and the safety of such chemotherapy as primary treatment in unresectable NBs, PATIENTS AND METHODS Patient populationUntreated children aged from 0 to 16 years were eligible. The primary tumour was evaluated using computerized tomography (CT)-scan or magnetic resonance imaging (MRI) as well as metaiodobenzylguanidine (MIBG) scintigraphy. Work-up to eliminate metastatic spread included the skeletal study by MIBG (or a 99mTc scan in the absence of MIBG uptake at the primary site), radiograph in infants and extensive bone marrow staging (at least two aspirations and two trephine biopsies). Urinary catecholamines (VMA, HVA and dopamine), serum neuron-specific enolase (NSE), ferritin and lactate dehydrogenase (LDH) levels were measured. The diagnosis of NB was always confirmed by cytological or histological documentation. The primary tumour was staged according to TNM (Beahrs, 1983) and INSS (Brodeur et al, 1993). However, those unresectable NBs did not overlap completely with INSS stage 3 tumours. Indeed, according to our definition of resectability using radiological data, those tumours were not operated first and some of them were INSS stage 2 (i.e. lateral tumours encasing regional organs or vessels and dumbbell tumours). Analysis of the N-myc oncogene (Seeger et al, 1985)

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Primary Chemotherapymentioning

confidence: 95%

Section: Outcomementioning

confidence: 99%

See 2 more Smart Citations

Unresectable localized neuroblastoma: improved survival after primary chemotherapy including carboplatin-etoposide

Michon¹,

Plantaz²,

Peyroulet³

et al. 1998

Br J Cancer

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show abstract

“…Indeed, 20% of patients presented with a symptomatic dumb-bell tumour. In such a situation, any treatment has to be delivered in emergency to avoid neurologic sequelae and we already reported the efficacy of that chemotherapy as an alternative to decompressive laminectomy in order to prevent orthopaedic sequelae as well (Plantaz et al, 1996). This strategy also seems appropriate for children presenting with slight neurological symptoms.…”

Section: Discussionmentioning

confidence: 99%

Localised and unresectable neuroblastoma in infants: excellent outcome with low-dose primary chemotherapy

Rubie

Coze

Plantaz³

et al. 2003

Br J Cancer

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The purpose of this study was to evaluate the efficacy of low-dose chemotherapy in infants with localised and unresectable neuroblastoma (NB). All consecutive infants with localised NB and no N-myc amplification were eligible in the SFOP-NBL 94 study. Primary tumour was deemed as unresectable according to imaging data showing any risk of immediate resection. Diagnostic procedures and staging were conducted according to INSS recommendations. For children, provided that they had no threatening symptom (i.e. vital risk or dumb-bell NB with neurologic deficit), chemotherapy consisted in low-dose cyclophosphamide (5 mg À1 kg day À1 Â 5 days) and vincristine (0.05 mg kg À1 at day 1) -CV and repeated one to three times every 2 weeks until surgical excision can be safely performed. No postoperative treatment was given. Between January 1995 and December 1999, 134 consecutive infants with localised NB were registered in the study, of whom 39 had an unresectable NB without N-myc amplification. Among them 28 had no threatening symptom and received CV according to the protocol. Objective response was observed in 14 (50%) and the other 14 were given second-line chemotherapy because of no response. Surgery was attempted in 38 patients including 14 after CV alone, leading to complete resection in 23. Relapses occurred in four patients all local. Survival and event-free survival were 100 and 9075% with a median follow-up of 55 months (range 33 -93). In conclusion primary low-dose chemotherapy without anthracyclines is efficient in about half of the infants presenting with an unresectable NB and no N-myc amplification, allowing excellent survival rates without jeopardising their long-term outcome even for nonresponding patients who received standard regimen.

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Long-term outcome of patients with intraspinal neuroblastoma

Hoover

Bowman

Crawford

et al. 1999

Med. Pediatr. Oncol.

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The treatment of neuroblastoma with intraspinal extension with chemotherapy followed by surgical removal of residual disease: A prospective study of 42 patients--Results of the NBL 90 study of the French Society of Pediatric Oncology

Cited by 102 publications

References 25 publications

Unresectable localized neuroblastoma: improved survival after primary chemotherapy including carboplatin-etoposide

Unresectable localized neuroblastoma: improved survival after primary chemotherapy including carboplatin-etoposide

Localised and unresectable neuroblastoma in infants: excellent outcome with low-dose primary chemotherapy

Long-term outcome of patients with intraspinal neuroblastoma

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