title: [Curative effects of the protocol of CDV combined with CiE as pre-operative chemotherapy in high-risk childhood neuroblastoma].
abstract: OBJECTIVE
  To evaluate the effects and the toxicity of the protocol of CDV combined with CiE as pre-operative chemotherapy in childhood stage IV neuroblastoma.
  
  
  METHODS
  The clinical data of 27 children aged from 1.2 to 8 years with neuroblastoma in stage IV was retrospectively studied. The primary sites of the diseases were abdomen (n = 21), posterior mediastinum (n = 4) and pelvic cavity (n = 2). Twenty three patients had bone marrow metastasis. Twelve patients had bone metastasis. All patients were treated with the CDV protocol (cyclophosphamide + doxorubicin + vincristine) for 3 cycles and the CiE protocol (cisplatin + etoposide) for 2 cycles. Neuroblastoma therapeutic response evaluation criterion and common terminology criteria for adverse events of National Cancer Institute were used to evaluate effects and chemotherapy related toxicity.
  
  
  RESULTS
  All patients received the pre-operative chemotherapy. The overall response rate was 82%. After chemotherapy, 24 patients received operations. Total resection of primary tumor was found in 14 patients (58%) and part resection in 10 patients (42%). The most common chemotherapy related toxicity was bone marrow suppression: grade IV suppression of neutrophils (n = 27), reduction in hemoglobin (III grade, n = 7; IV grade, n = 20) and reduction in platelet (III grade, n = 2; IV grade, n = 25). Infection was found in all patients and was controlled with antibiotics. I or II grade lesions of digestive, liver and kidney were found and could be recovered after therapy. Grade I neurotoxicity occurred in 2 patients (7%). The heart function damage was not found in any of patients.
  
  
  CONCLUSIONS
  The protocol of CDV combined with CiE as pre-operative chemotherapy might be effective in children with stage IV neuroblastoma.
authors.affiliation: Department of Pediatrics, People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Feng
authors.forename: Suo-Qin
authors.initials: SQ
authors.lastname: Tang
authors.forename: Jian-Wen
authors.initials: JW
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Guang
authors.initials: G
authors.lastname: Yang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009447:Neuroblastoma / Q000188:drug therapy*; D012189:Retrospective Studies; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D014750:Vincristine; D005047:Etoposide; D003606:Dacarbazine; D003520:Cyclophosphamide; D002945:Cisplatin