Outcome of children older than one year with neuroblastoma

Objectives: To assess the outcome of children older thanone year with neuroblastoma treated at King Abdul-AzizMedical City, Jeddah, Kingdom of Saudi Arabia.Methods: We retrospectively reviewed the files of52 children older than one year with neuroblastoma(NBL) treated at our center between September1987 and May 2003. Treatment consisted of OPEC chemotherapy regimen (vincristine, cisplatin, etoposide,and cyclophosphamide) or alternating OPEC/OJEC(carboplatin in place of cisplatin), surgical resection ±radiotherapy (RT). No patient received high dose therapy(HDT).Results: Thirty-four patients (65%) were stage 4, 12(23%) stage 3, and 6 (11%) stage 2. Three stage 2 patients were treated with surgery only, all are alive in complete remission (CR). All stage 3 and 4 patients were treated with chemotherapy and surgery ± RT. After induction chemotherapy, CR was achieved in 17 patients (32%)and partial remission in 10 (19%). Complete surgical resection was possible in 11 patients (22%). Disease recurrence or progression occurred in 27 patients (51%).With a median follow-up of 24 months (range 4-120),the 2-year event free survival was 10%, 82%, and 87%and the overall survival was 12%, 83%, and 100% forstage 4, 3, and 2.Conclusions: Children older than one year with localized NBL have good prognosis compared to those with stage 4. The use of HDT may improve the outcome in thelatter group. Toxicity was significant, and adoption ofrisk-stratified treatment may help to reduce treatment complications.