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High-dose chemotherapy followed by locoregional irradiation improves the outcome of patients with international neuroblastoma staging system Stage II and III neuroblastoma with MYCN amplification
Version of Record online: 16 JUL 2004
Copyright © 2004 American Cancer Society
Volume 101, Issue 5, pages 1081–1089, 1 September 2004
How to Cite
Laprie, A., Michon, J., Hartmann, O., Munzer, C., Leclair, M.-D., Coze, C., Valteau-Couanet, D., Plantaz, D., Carrie, C., Habrand, J.-L., Bergeron, C., Chastagner, P., Défachelles, A.-S., Delattre, O., Combaret, V., Bénard, J., Pérel, Y., Gandemer, V., Rubie, H. and Neuroblastoma Study Group of the French Society of Pediatric Oncology (2004), High-dose chemotherapy followed by locoregional irradiation improves the outcome of patients with international neuroblastoma staging system Stage II and III neuroblastoma with MYCN amplification. Cancer, 101: 1081–1089. doi: 10.1002/cncr.20453
- Issue online: 18 AUG 2004
- Version of Record online: 16 JUL 2004
- Manuscript Accepted: 24 MAY 2004
- Manuscript Revised: 19 MAY 2004
- Manuscript Received: 30 MAR 2004
- Association pour la Recherche contre le Cancer and Clinical Research Program of the Ministry of Health. Grant Number: 35-06-N
- high-risk neuroblastoma;
- high-dose chemotherapy;
- stem cell rescue
The objective of this study was to determine whether systemic and regional, intensified treatment can improve the outcome of children who present with a localized neuroblastoma (NB) with MYCN amplification (MNA).
Between 1990 and 2000, 610 children with localized NB were included in the Localized Neuroblastoma 90 (NBL 90) and NBL 94 study from the French Society of Pediatric Oncology. Among them, 32 children had MNA with Stage II or III NB. During the first period of the study, 20 children (Group A) received postoperative conventional chemotherapy (CT) and/or radiotherapy (RT), depending on each patient's postoperative status. Subsequently, because of a high recurrence rate, the next 12 children (Group B) were given postoperative high-dose CT (HDC) (busulfan and melphalan) with stem cell rescue (SCR) followed by RT in addition to conventional postoperative CT.
The two groups were comparable with regard to prognostic factors (age, location of the primary lesion, International Neuroblastoma Staging System stage, lymph node invasion) and response to preoperative CT. The 6-year overall survivalrate was significantly different between the two groups 25% ± 10% in Group A vs. 83% ± 11% in Group B; P = 0.004).
Postoperative intensification treatment with HDC, SCR, and locoregional RT resulted in higher survival rates when compared with standard treatment alone and should be considered in the treatment plan for children who are diagnosed with Stage II or III NB and MYCN amplification. Cancer 2004. © 2004 American Cancer Society.