Treatment of high-risk neuroblastoma: National protocol results of the Turkish Pediatric Oncology Group.


BACKGROUND The national protocol aimed to improve the outcome of the high risk neuroblastoma patients by high-dose chemotherapy and stem cell rescue with intensive multimodal therapy. MATERIALS AND METHODS After the 6 induction chemotherapy cycles, patients without disease progression were nonrandomly (by physicians' and/or parent's choices) allocated into two treatment arms, which were designed to continue the conventional chemotherapy (CCT), or myeloablative therapy with autologous stem cell rescue (ASCR). RESULTS Fifty-six percent (272 patients) of patients was evaluated as high risk. Response rate to induction chemotherapy was 71%. Overall event-free survival (EFS) and overall survival (OS) at 5 years were 28% and 36%, respectively. "As treated" analysis documented postinduction EFS of 41% in CCT arm (n = 138) and 29% in ASCR group (n = 47) (P = 0.042); whereas, OS was 45% and 39%, respectively (P = 0.05). Thirty-one patients (11%) died of treatment-related complications. CONCLUSION Survival rates of high-risk neuroblastoma have improved in Turkey. Myeloablative chemotherapy with ASCR has not augmented the therapeutic end point in our country's circumstances. The adequate supportive care and the higher patients' compliance are attained, the better survival rates might be obtained in high-risk neuroblastoma patients received myeloablative chemotherapy and ASCR.

DOI: 10.4103/0973-1482.183205

Cite this paper

@article{Aksoylar2017TreatmentOH, title={Treatment of high-risk neuroblastoma: National protocol results of the Turkish Pediatric Oncology Group.}, author={Serap Aksoylar and Ali Varan and Canan Vergin and Volkan Hazar and Ferhan Akici and Ayhan Dağdemir and Mustafa Buyukavci and Rejin Kebudi and Nilgun Kurucu and Betul Berrin Sevinir and Emel Cabi Unal and Sema Vural and Elif Guler and Hilmi Apak and Haldun Oniz and Ceyda Karadeniz and Cengiz Canpolat and S Sema Anak and Inci Ergurhan Ilhan and Dilek Ince and Emre Çeçen and Nur Olgun}, journal={Journal of cancer research and therapeutics}, year={2017}, volume={13 2}, pages={284-290} }