title: [Efficacy of chemotherapy regimen using ifosphamide and carboplatin on recurrent or refractory neuroblastoma].
abstract: OBJECTIVE
  About 30% of neuroblastoma patients have poor response to first-line chemotherapy or progress during chemotherapy. Although advanced neuroblastoma patients could achieve complete remission after combined treatment, most of them relapsed finally. This study was to evaluate the efficacy of ifosphamide and carboplatin as a salvage chemotherapy regimen on recurrent or refractory neuroblastoma.
  
  
  METHODS
  Nine refractory neuroblastoma patients and 23 recurrent neuroblastoma patients were treated with ifosphamide (1.5 g/m(2) daily for 5 days) and carboplatin (400 mg/m(2) on day 1). Mesna was applied at a dosage of 20% of ifosfamide 3 times at 4-hour intervals after termination of the ifosfamide infusion. Chemotherapy was administered every 2-3 weeks.
  
  
  RESULTS
  None of the 32 patients achieved complete remission; 19 (59.4%) achieved partial remission. The median remission time was 4.2 months (1-28 months). After chemotherapy, 8 patients received operation to resect tumors. Main adverse events included grade III-IV neutropenia (44.7%), grade III-IV thrombocytopenia (53.1%), neutropenia accompanied with infection (18.8%), grade I liver dysfunction (12.5%), and hemorrhagic cystitis (9.4%). All adverse events were reversible.
  
  
  CONCLUSIONS
  Recurrent and refractory neuroblastoma responds well to chemotherapy regimen of ifosphamide plus carboplatin. The toxicities are tolerable. But the long-term prognosis is poor. More effective strategies are needed to improve its long-term survival.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
authors.forename: Zi-Jun
authors.initials: ZJ
authors.lastname: Zhen
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Sun
authors.forename: Yi
authors.initials: Y
authors.lastname: Xia
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Wang
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Ling
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018305:Ganglioneuroblastoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage* / Q000009:adverse effects; D007223:Infant; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D009364:Neoplasm Recurrence, Local; D009447:Neuroblastoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012074:Remission Induction; D016879:Salvage Therapy; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D018906:Antineoplastic Agents, Alkylating; D016190:Carboplatin; D007069:Ifosfamide