CHEMOTHERAPY OF ADVANCED NEURO-BLASTOMA - DOES ADRIAMYCIN CONTRIBUTE

Between 1970-1977, 69 children with newly diagnosed stage III or IV neuroblastoma were treated with pulses of either cyclophosphamide and vincristine (CV) (n = 23), or cyclophosphamide, vincristine and adriamycin (CVA) (n = 46). The complete and partial response rates were 35 and 22% to CV, and 43 and 26% to CVA. For complete responders the median time to relapse was 18 mo. for those treated with CV and 17 mo. for those treated with CVA; for partial responders the times were 5 and 7 mo., respectively. At 2 1/2 yr only 17% of the CV patients and only 13% of the CVA patients were alive and free of disease, giving a 15% overall survival rate. The addition of adriamycin to cyclophosphamide and vincristine did not significantly improve the response rate, duration of response or survival in these children with advanced neuroblastoma. The previously noted favorable effects of age < 1 yr at diagnosis and of female sex were confirmed. The equally poor survival for stage III and stage IV patients justifies the inclusion of stage III patients in a bad prognosis group.