The CancerWeb Report, What's New In Cancer: September, 1996
Neuroblastoma

• Chemoradiotherapy and bone marrow transplantation is superior to continuing chemotherapy in metastatic neuroblastoma - This was the result reported by the Children's Cancer Group, a cooperative effort of clinicians throughout the US, in the September issue of the Journal of Clinical Oncology. Of 159 patients with Stage IV advanced metastatic neuroblastoma who responded to initial induction chemotherapy with cisplatin, etoposide, doxorubicin and cyclophosphamide, 67 received intensive chemoradiotherapy and autologous bone marrow transplantation, while 74 continued on chemotherapy for 13 total courses. Four-year disease-free survival reached 40% in the chemoradiotherapy/transplantation group versus only 19% in those continuing on chemotherapy alone. The improvement was especially marked among those who had only a partial response to induction chemotherapy (4-year survival 29% versus 6%), as well as in those whose tumors manifested increased levels of the N-myc oncogene (67% versus 0%). (Stram, J Clin Oncol 14:2417, 1996)

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• Is initial postoperative adjuvant treatment necessary in low-stage neuroblastoma? - The results reported from the Children's Hospital of Philadelphia in the September, 1996 issue of the Journal of Clinical Oncology indicate that it is possible to consider most low-stage neuroblastoma as favorable disease and omit adjuvant treatment after initial surgery. Researchers examined their patient data over the decades 1972-1981 and 1982-1992 and found that overall 5-year survival was 68% for those receiving adjuvant therapy and 94% for those who did not; the corresponding event-free (without evidence of disease recurring) survivals were 52% and 86%. Over time, the fraction of children given adjuvant therapy has declined from 29% to 10% because of the introduction of new prognostic tests as guides to treatment. Five-year survival rates for those without adjuvant treatment were 85% in the first and 98% in the second decade studied. (Evans, J Clin Oncol 14:2504, 1996)