BACKGROUND: In children older than 1 year with localised unresectable neuroblastoma (NB), treatment strategies are heterogeneous according to the national groups. The objective of this phase III non-randomised study was to evaluate the efficacy of conventional chemotherapy followed by surgery. PATIENTS AND METHODS: In the presence of surgical risk factors (SRF), six courses of chemotherapy alternating Carboplatin-Etoposide and Vincristin-Cyclophosphamide-Doxorubicin were given, and surgical resection was attempted after four. Survival analyses were performed using an intention-to-treat approach. The main objective was to achieve a 5-year survival over 80%. RESULTS: Out of 191 registered children, 160 were evaluable. There were 62.5% older than 18 months and 52.5% had unfavourable histology according to International Neuroblastoma Pathology Classification (INPC). Chemotherapy reduced the number of SRFs by one third. Delayed surgery was attempted in 86.3% of patients and was complete or nearly complete in 74%. The 5-year EFS and OS were 76.4% and 87.6% respectively, with significant better results for patients younger than 18 months or with favourable histology. CONCLUSION: This strategy provides encouraging results in children older than 1 year or 12 months with localised unresectable NB without MYCN amplification. However, in children older than 18 months and with unfavourable histology, additional treatment is recommended.
BACKGROUND: In children older than 1 year with localised unresectable neuroblastoma (NB), treatment strategies are heterogeneous according to the national groups. The objective of this phase III non-randomised study was to evaluate the efficacy of conventional chemotherapy followed by surgery. PATIENTS AND METHODS: In the presence of surgical risk factors (SRF), six courses of chemotherapy alternating Carboplatin-Etoposide and Vincristin-Cyclophosphamide-Doxorubicin were given, and surgical resection was attempted after four. Survival analyses were performed using an intention-to-treat approach. The main objective was to achieve a 5-year survival over 80%. RESULTS: Out of 191 registered children, 160 were evaluable. There were 62.5% older than 18 months and 52.5% had unfavourable histology according to International Neuroblastoma Pathology Classification (INPC). Chemotherapy reduced the number of SRFs by one third. Delayed surgery was attempted in 86.3% of patients and was complete or nearly complete in 74%. The 5-year EFS and OS were 76.4% and 87.6% respectively, with significant better results for patients younger than 18 months or with favourable histology. CONCLUSION: This strategy provides encouraging results in children older than 1 year or 12 months with localised unresectable NB without MYCN amplification. However, in children older than 18 months and with unfavourable histology, additional treatment is recommended.
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17
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Authors: Joëlle Vermeulen; Katleen De Preter; Arlene Naranjo; Liesbeth Vercruysse; Nadine Van Roy; Jan Hellemans; Katrien Swerts; Sophie Bravo; Paola Scaruffi; Gian Paolo Tonini; Bruno De Bernardi; Rosa Noguera; Marta Piqueras; Adela Cañete; Victoria Castel; Isabelle Janoueix-Lerosey; Olivier Delattre; Gudrun Schleiermacher; Jean Michon; Valérie Combaret; Matthias Fischer; André Oberthuer; Peter F Ambros; Klaus Beiske; Jean Bénard; Bárbara Marques; Hervé Rubie; Janice Kohler; Ulrike Pötschger; Ruth Ladenstein; Michael D Hogarty; Patrick McGrady; Wendy B London; Geneviève Laureys; Frank Speleman; Jo Vandesompele Journal: Lancet Oncol Date: 2009-06-08 Impact factor: 41.316
Authors: Navin R Pinto; Mark A Applebaum; Samuel L Volchenboum; Katherine K Matthay; Wendy B London; Peter F Ambros; Akira Nakagawara; Frank Berthold; Gudrun Schleiermacher; Julie R Park; Dominique Valteau-Couanet; Andrew D J Pearson; Susan L Cohn Journal: J Clin Oncol Date: 2015-08-24 Impact factor: 44.544
Authors: Wayne H Liang; Sara M Federico; Wendy B London; Arlene Naranjo; Meredith S Irwin; Samuel L Volchenboum; Susan L Cohn Journal: JCO Clin Cancer Inform Date: 2020-10
Authors: Skye Balyasny; Sang Mee Lee; Ami V Desai; Samuel L Volchenboum; Arlene Naranjo; Julie R Park; Wendy B London; Susan L Cohn; Mark A Applebaum Journal: JAMA Netw Open Date: 2021-07-01