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Excellent Outcome With Reduced Treatment in Infants With Nonmetastatic and Unresectable Neuroblastoma Without MYCN Amplification: Results of the Prospective INES 99.1.
MedLine Citation:
PMID:  21172879     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE To evaluate the efficacy of low-dose chemotherapy in infants with nonmetastatic and unresectable neuroblastoma (NB) without MYCN amplification. PATIENTS AND METHODS Infants with localized NB and no MYCN amplification were eligible in the SIOPEN Infant Neuroblastoma European Study 99.1 study. Primary tumor was deemed unresectable according to imaging defined risk factors. Diagnostic procedures and staging were carried out according to International Staging System recommendations. Children without threatening symptoms received low-dose cyclophosphamide (5 mg/kg/d × 5 days) and vincristine (0.05 mg/kg at day 1; CyV), repeated once to three times every 2 weeks until surgical excision could be safely performed. Children with either one threatening symptom or insufficient response to CyV were given carboplatin and etoposide (CaE), sometimes followed by vincristine, cyclophosphamide, and doxorubicin. No postoperative treatment was to be administered. Results Between December 1999 and April 2004, 120 infants were included in the study. Eighty-eight had no threatening symptoms and 79 received CyV. CaE was given to 49 of them because of insufficient response. Thirty-two children had threatening symptoms, 30 of whom received CaE. Anthracyclines were given to 46 children. Surgery was attempted in 102 patients, leading to gross surgical excision in 93. Relapse occurred in 12 patients (nine local and three metastatic). Five-year overall and event-free survivals were 99% ± 1% and 90% ± 3%, respectively, with a median follow-up of 6.1 years (range, 1.6 to 9.1). CONCLUSION Low-dose chemotherapy without anthracyclines is effective in 62% of infants with an unresectable NB and no MYCN amplification, allowing excellent survival rates without jeopardizing their long-term outcome.
Authors:
Hervé Rubie; Bruno De Bernardi; Mary Gerrard; Adela Canete; Ruth Ladenstein; Jérôme Couturier; Peter Ambros; Caroline Munzer; Andrew D J Pearson; Alberto Garaventa; Penelope Brock; Victoria Castel; Dominique Valteau-Couanet; Keith Holmes; Andrea Di Cataldo; Bénédicte Brichard; Véronique Mosseri; Catalina Marquez; Dominique Plantaz; Luca Boni; Jean Michon
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Publication Detail:
Type:  Journal Article     Date:  2010-12-20
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  29     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  449-55     Citation Subset:  IM    
Affiliation:
Unité d'Hémato-Oncologie, Hôpital des Enfants, 330 Avenue de Grande Bretagne TSA 70034, 31059 Toulouse Cedex 9, France; rubie.h@chu-toulouse.fr.
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