title: D-CECaT as preoperative chemotherapy for unresectable neuroblastoma in children over one year of age.
abstract: The role of intensive pre- and postoperative chemotherapy in unresectable nonmetastatic neuroblastoma is still controversial. A preoperative regimen that included deferoxamine, cyclophosphamide, etoposide, carboplatin and thiotepa (D-CECaT) was evaluated in 10 children over one year of age at diagnosis, and this was followed by surgery and postoperative chemotherapy. After four courses of D-CECaT, the response rate was 9/10 with 3 complete responses, 6 partial responses and 1 minor response. Severe but transitory myelosuppression was the major toxic effect. Complete remission by combined D-CECaT chemotherapy and surgery was obtained in 9/10 patients, while 1 case achieved complete remission only with postoperative chemotherapy. All children are disease-free with a median follow-up of 30.5 months (range: 1+ to 50+). This intensive treatment was effective in both standard- and high-risk unresectable NB. However, whether a less intensive approach and fewer courses can also give similar results in standard-risk cases warrants further study.
authors.affiliation: Division of Oncology, Ospedale Bambino Gesù, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Donfrancesco
authors.forename: G
authors.initials: G
authors.lastname: Deb
authors.forename: C
authors.initials: C
authors.lastname: Dominici
authors.forename: L
authors.initials: L
authors.lastname: De Sio
authors.forename: A
authors.initials: A
authors.lastname: Inserra
authors.forename: C
authors.initials: C
authors.lastname: Boglino
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: J
authors.initials: J
authors.lastname: Uchino
authors.forename: L
authors.initials: L
authors.lastname: Helson
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003676:Deferoxamine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D009447:Neuroblastoma / Q000188:drug therapy* / Q000601:surgery; D013852:Thiotepa / Q000008:administration & dosage
chemical_list: D005047:Etoposide; D003520:Cyclophosphamide; D013852:Thiotepa; D016190:Carboplatin; D003676:Deferoxamine