High-dose rapid schedule chemotherapy for disseminated neuroblastoma

Eur J Cancer. 1992;28A(10):1654-9. doi: 10.1016/0959-8049(92)90062-7.

Abstract

In a high-dose schedule for disseminated neuroblastoma, eight courses of chemotherapy were administered every 10 days, regardless of myelosuppression, to eradicate tumour cells rapidly and reduce emergence of drug-resistant clones. Relatively non-myelotoxic vincristine and cisplatin were alternated with high-dose cisplatin-etoposide and cyclophosphamide-etoposide. Of 12 evaluable patients, there were 1 complete (CR), 3 very good partial (VGPR), 5 partial (PR) and 3 mixed responses (MR) 100 days after starting treatment. 6 out of 9 achieved a bone marrow CR at 40 days. 9 of 11 primary tumours were completely resected, after which 4 patients had CR, 3 VGPR (bone scan alone being abnormal), 4 PR and 1 mixed response (MR). Myelotoxicity was the major adverse effect. The only death was due to fungal infection. Clinically important renal dysfunction occurred in 3 patients. 4 had convulsions and 4 temporary hypertension. This schedule produced a rapid response and its toxicity, though serious, was manageable. Further evaluation is warranted.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Drug Administration Schedule
  • Etoposide / administration & dosage
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Neuroblastoma / drug therapy*
  • Neuroblastoma / secondary*
  • Neutrophils / drug effects
  • Platelet Count / drug effects
  • Vincristine / administration & dosage

Substances

  • Vincristine
  • Etoposide
  • Cyclophosphamide
  • Cisplatin