MULTIPLE DRUG CHEMOTHERAPY + AGGRESSIVE MULTIPLE SURGERY + RADIATION THERAPY IN THE TREATMENT OF ADVANCED NEUROBLASTOMA

Eight patients between the ages of 1.5-13 years with 3 stage III and 5 stage IV disease were treated with OPEC regimen consisting of vincristine + cisplatin -/+ VM 26 -/+ cylophoshamide and 6 drug regimen consisting of vincistine + cisplatin + epirubicin + VP-16 + DTIC + cyclophosphamide. They also underwent multiple aggressive surgery + radiation therapy. A response rate of 75 % (3 CR + 3PR) was achieved after 1-17 months (median 12 months duration. Although the preliminary results have shown substantial tumor response rate, more time is needed to give long term survival and disease free survival rates. Myelosuppression, cardiotoxicity, nephrotoxicity and ototoxicity were the major complications of chemotherapy.