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Research ArticleOriginal Article
Open Access

Neuroblastoma

Hadir M. Meir, Ibrahim Balawi, Hala Nayel, Mohammad K. Yousef, Sami Badawood and Mohammad Al-Mobarak
Saudi Medical Journal August 2001, 22 (8) 674-680;
Hadir M. Meir
King Abdul Aziz Hospital & Oncology Center, PO Box 31467, Jeddah 21497, Kingdom of Saudi Arabia. Fax. +966 (2) 6379442.
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Ibrahim Balawi
King Abdul Aziz Hospital, Jeddah, Kingdom of Saudi Arabia.
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Hala Nayel
King Abdul Aziz Hospital, Jeddah, Kingdom of Saudi Arabia.
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Mohammad K. Yousef
King Abdul Aziz Hospital, Jeddah, Kingdom of Saudi Arabia.
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Sami Badawood
King Abdul Aziz Hospital, Jeddah, Kingdom of Saudi Arabia.
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Mohammad Al-Mobarak
King Abdul Aziz Hospital, Jeddah, Kingdom of Saudi Arabia.
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Abstract

OBJECTIVE: Due to the poor results achieved on combination chemotherapy and the unproven cost-effectiveness value of myeloablative therapy, the question has been raised; should patients with stage IV neuroblastoma be actively treated? The aim of the current study is to analyze retrospectively treatment results of 43 children with neuroblastoma with special stress on the rate and duration of remission in children with disseminated neuroblastoma.

METHODS: Treatment of children with neuroblastoma consisted of surgical removal of the tumor, if possible, followed by chemotherapy for unresectable residual tumor including metastases. Second look surgery was performed to resect residual masses rendered resectable on chemotherapy in the absence of distal metastases. The chemotherapy protocol used in the current study consisted of alternating combination chemotherapy regimens containing, Cyclophosphamide, Vincristine and Doxorubicin, alternating with Cis-platinum and Etoposide.

RESULTS: The male to female ratio was 2:1 with a median age of 2.1 years. The abdomen was the primary site of involvement encountered in 32 patients (74%). According to the childrens cancer study group (CCSG) staging system, only 6 patients (14%) had localized tumors (stages I and II). Two patients (5%) were found to have stage IV. Stage III was documented in 5 patients (12%). The majority of patients (70%) had disseminated disease at presentation. The bone marrow was the most common site of metastatic deposit, encountered in 23 patients out of the 30 with stage IV disease (77%). Out of the 12 evaluable non-stage IV patients, only one patient (8%) showed treatment failure. Assessment of response by the end of the 6th month from the date of diagnosis revealed that out of the 27 evaluable patients with stage IV, 4 patients achieved complete remission, 7 patients achieved very good partial remission, 8 patients achieved partial remission and 4 patients achieved mixed response. Three patients showed progressive disease on chemotherapy. Twenty-one patients (78%) were symptom-free and were conducting normal life. Assessment of response to treatment by the end of the 12th month from diagnosis revealed that 6 patients (2 complete remissions, 1 very good partial response, 3 partial responses) were maintaining their remission. Out of the 19 patients showing complete or partial remission at early assessment, 4 patients maintained their remission for more than 18 months. Two (one was in complete remission and the other was in partial response) of them progressed in areas of previous involvement after 20 and 21 months. The other 2 patients (one was in complete remission and the other was in partial response) showed disease progression in areas not previously affected by disease at presentation after 23 and 42 months.

CONCLUSION: Results of treatment by multiagent chemotherapy regimens used in the current study show that children with neuroblastoma, even those with advanced stages, should receive the benefit of intensive multimodal therapy, even those with partial response to initial therapy. These patients may experience reasonable symptom-free and sometimes, disease-free survival.

  • Copyright: © Saudi Medical Journal

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Saudi Medical Journal: 22 (8)
Saudi Medical Journal
Vol. 22, Issue 8
1 Aug 2001
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Neuroblastoma
Hadir M. Meir, Ibrahim Balawi, Hala Nayel, Mohammad K. Yousef, Sami Badawood, Mohammad Al-Mobarak
Saudi Medical Journal Aug 2001, 22 (8) 674-680;

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Neuroblastoma
Hadir M. Meir, Ibrahim Balawi, Hala Nayel, Mohammad K. Yousef, Sami Badawood, Mohammad Al-Mobarak
Saudi Medical Journal Aug 2001, 22 (8) 674-680;
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© 2025 Saudi Medical Journal Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention.  Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3175. Print ISSN 0379-5284.

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