Staging and Treatment of Neuroblastoma.

Advances in the treatment of neuroblastoma have been sparse in the past decade. This common tumor of childhood has not participated in the success seen in other pediatric solid tumors. Patients with local resectable tumors probably do not require irradiation (RT) or adjuvant chemotherapy. Gross residual disease (usually Stage III) does benefit from RT, and the value of chemotherapy has yet to be determined. Stage IV patients may not require resection of the primary; chemotherapy assumes a major role. Combinations, which include cyclophosphamide, vincristine, Adriamycin, and imidazole carboxamide have induced responses in more than 50% of patients. Survival though has improved little in spite of good response rates.