Resistant and relapsing neuroblastoma: improved response rate with a new multiagent regimen (OC-HDP) including high-dose cisplatinum.

From September 1984 to July 1985, 11 children from 6 months to 6 years of age were treated with a three-drug regimen (OC-HDP), including vincristine, cyclophosphamide, and cisplatinum 200 mg/m2 given as five dose-fractions over 5 days. Nine had resistant and two relapsed neuroblastoma. Nine children had previously been treated with cisplatinum at conventional doses; nine had not received cyclophosphamide and ten had not received vincristine. Nine of eleven patients had a good response to treatment; six are presently alive in continuous complete remission 11-23 months (median 13 months) after diagnosis. Toxicity was moderate: no child showed either severe myelotoxicity or clinical or laboratory evidence of nephrotoxicity. No child had clinically significant ototoxicity. In six children audiometry showed hearing loss for high frequencies after the third cycle of treatment. It is concluded that OC-HDP regimen could be considered as a first-line treatment for advanced neuroblastoma.