| The treatment of neuroblastoma with intraspinal extension with chemotherapy followed by surgical removal of residual disease. A prospective study of 42 patients--results of the NBL 90 Study of the French Society of Pediatric Oncology. | |
| | |
MedLine Citation:
|
PMID: 8674009 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Neuroblastoma is the most common malignant cause of spinal compression in the pediatric population. More than 30% of patients who are impaired prior to treatment remain impaired after the completion of therapy. Those who do not improve after decompressive laminectomy may go on to develop severe delayed spinal deformities. METHODS: To decrease the long term sequelae of routine neurosurgical intervention for all intraspinal extensions of neuroblastoma, the French NBL 90 Study was formulated to use chemotherapy as a first-line treatment for all nonmetastatic neuroblastomas with intraspinal extension. Neurosurgical decompression and excision was recommended only for patients demonstrating rapid neurologic deterioration. RESULTS: The overall survival of the 42 patients registered was 97%. Initial neurologic impairment was present in 27 patients (64%), including 11 with paraplegia. Thirty-two patients received chemotherapy as first-line treatment. Complete regression of the intraspinal component was observed in 13 patients and partial regression of greater than 50% of the initial volume in 5 patients. Of 19 evaluable patients presenting with a neurologic deficit and treated with primary chemotherapy, recovery was completed in 11 and partial in 3. Four patients failed to recover from long-standing pretreatment paraplegia. Only one patient worsened during therapy, and recovered completely after emergent neurosurgical intervention. Seven patients underwent initial neurosurgical procedures; six had a neurologic deficit and five recovered completely, including all three who presented with acute onset of paraplegia. Three patients had extraspinal surgery as exclusive treatment. Six patients (15%) suffered severe neurologic sequelae. Only one of the patients who underwent surgery required spinal stabilization for progressive deformity, but follow-up is limited. CONCLUSIONS: By treating patients with dumbbell neuroblastoma initially with chemotherapy, the authors were able to reduce the size of the intraspinal mass in 58% of patients, improve partial neurologic deficits in 92%, and avoid neurosurgical decompression in 60%. Neurologic deficits also improved in 83% of patients requiring emergent neurosurgical intervention. |
| | |
Authors:
|
D Plantaz; H Rubie; J Michon; F Mechinaud; C Coze; P Chastagner; D Frappaz; M Gigaud; J G Passagia; O Hartmann |
Related Documents
:
|
11172179 - Fomepizole for the treatment of methanol poisoning. 16998759 - Adverse effects of treatment with intravenous immunoglobulins for neurological diseases. 4009339 - Behçet syndrome. 16330599 - Neurological soft signs in first-episode schizophrenia: a follow-up study. 4083849 - Fragile x syndrome: associated neurological abnormalities and developmental disabilities. 7601389 - Clinical and electrophysiologic study of the brain and peripheral nerves disorders in c... 20149309 - Does acute synovitis (pseudogout) occur in patients with chronic pyrophosphate arthropa... 21273739 - Evaluation of combined use of transcranial and direct cortical motor evoked potential m... 6826099 - Absorption of prednisolone in patients with crohn's disease. |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Cancer Volume: 78 ISSN: 0008-543X ISO Abbreviation: Cancer Publication Date: 1996 Jul |
Date Detail:
|
Created Date: 1996-08-15 Completed Date: 1996-08-15 Revised Date: 2010-03-24 |
Medline Journal Info:
|
Nlm Unique ID: 0374236 Medline TA: Cancer Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 311-9 Citation Subset: AIM; IM |
Affiliation:
|
Pediatric Department, Centre Hospitalier Universitaire, Hospital Michallon, Grenoble, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Antineoplastic Combined Chemotherapy Protocols / administration & dosage, therapeutic use* Child Child, Preschool Female Follow-Up Studies France Humans Infant Infant, Newborn Laminectomy Male Neoplasm, Residual / surgery Neuroblastoma / complications, drug therapy*, surgery* Neurologic Examination Paraplegia / etiology Prospective Studies Remission Induction Spinal Cord Compression / etiology, surgery Spinal Neoplasms / complications, drug therapy*, surgery* Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Pregnancy-associated lymphomas. A clinicopathologic study.
Next Document: The biologic dilemma of early carcinoma of the prostate.