A CASE SERIES OF CHILDREN WITH HIGH-RISK METASTATIC NEUROBLASTOMA TREATED WITH A NOVEL TREATMENT STRATEGY CONSISTING OF POSTPONED PRIMARY SURGERY UNTIL THE END OF SYSTEMIC CHEMOTHERAPY INCLUDING HIGH-DOSE CHEMOTHERAPY

Abstract

The aim of this study was to clarify the feasibility of a novel treatment strategy consisting of postponed primary surgery till the end of systemic chemotherapy including HDC without interruption by local therapy for neuroblastoma patients at a high risk for relapse. After induction chemotherapy, patients received double conditioning HDC consisting of thiotepa and melphalan. Radical surgery was applied to local lesions. Irradiation was not applied to any lesions. Eleven consecutive pediatric neuroblastoma patients were treated according to this strategy. Seven of 11 patients remained in complete remission for 21–171 months. This treatment strategy seems feasible and a further study is warranted.

Keywords:

• delayed primary surgery
• high-dose chemotherapy
• high-risk neuroblastoma
• melphalan
• thiotepa