Low-dose protracted irinotecan as a palliative chemotherapy for advanced neuroblastoma.

Management of cases of refractory neuroblastoma remains a challenge. As intensive chemotherapy sometimes results in severe regimen-related toxicity and poor quality of life, palliative chemotherapy with modest toxicity may be considered for these cases. We report 2 cases of stage 4 neuroblastoma with poor performance status that received low-dose protracted schedules of irinotecan. This regimen achieved not only disease stabilization but also dramatic improvements of quality of life for significant periods. A low-dose protracted schedule of irinotecan was tolerable even if the patient's performance status was poor, and thus might be useful as a palliative chemotherapy for advanced neuroblastoma.