title: Advanced neuroblastoma: results of two treatment programs including sequential hemibody irradiation.
abstract: Results of two consecutive treatment programs for advanced neuroblastoma, including sequential hemibody irradiation, are analyzed and compared. The first treatment program (I-TP) included one single-fraction (7 Gy) irradiation to the upper and lower halves of the body as consolidation of remission achieved by previous chemotherapy with CDDP and VP16. A fractionated technique (2 Gy daily for 4 consecutive days to each hemibody) was used in the second treatment program (II-TP) for children in remission following a combination of CDDP + VP16 and ADM + VCR + CTX. In both treatment programs, chemotherapy was continued according to the same pre-radiation regimen following the two sessions of hemibody irradiation. Overall response rate to pre-radiation chemotherapy was 84% and 60% for I-TP and II-TP, respectively. Thirty-month overall progression-free survival was 0 for I-TP and 20% for II-TP. No treatment-related fatalities occurred. In the subsets of patients who reached complete or good partial remission during the pre-radiation chemotherapeutic phase, 30-month progression-free survival in I-TP and II-TP was 0 and 33%, respectively. The role of fractionated hemibody irradiation in prolonging the progression-free survival can be inferred.
authors.affiliation: Istituto Nazionale per lo Studio e la Cura dei Tumori Via Venezian, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Lombardi
authors.forename: L
authors.initials: L
authors.lastname: Rottoli
authors.forename: C
authors.initials: C
authors.lastname: Gianni
authors.forename: L
authors.initials: L
authors.lastname: Gandola
authors.forename: A
authors.initials: A
authors.lastname: Lattuada
authors.forename: F
authors.initials: F
authors.lastname: Fossati-Bellani
authors.forename: M
authors.initials: M
authors.lastname: Gasparini
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009447:Neuroblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy; D014750:Vincristine / Q000008:administration & dosage; D014916:Whole-Body Irradiation
chemical_list: D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin