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Cycles # Chemotherapy Agents Dosage Day of treatment 1 and 7 Carboplatin 18.6 mg/kg/dose ≤ 12 kg or 560 mg/m²/dose > 12 kg Day 1 Etoposide 4 mg/kg/dose ≤ 12 kg or 120 mg/m2/dose > 12 kg Days 1-3 2 and 6 Carboplatin 18.6 mg/kg/dose ≤ 12 kg or 560 mg/m²/dose > 12 kg Day 1 Cyclophosphamide 33.3 mg/kg/dose for patients ≤ 12 kg or 1000 mg/m2/dose for patients > 12 kg Day 1 Doxorubicin 1 mg/kg/dose for patients ≤ 12 kg or 30 mg/m2/dose for patients > 12 kg Day 1 3 and 5 Cyclophosphamide 33.3 mg/kg/dose for patients ≤ 12 kg or 1000 mg/m2/dose for patients > 12 kg Day 1 Etoposide 4 mg/kg/dose ≤ 12 kg or 120 mg/m2/dose > 12 kg Days 1-3 4 Carboplatin 18.6 mg/kg/dose ≤ 12 kg or 560 mg/m²/dose > 12 kg Day 1 Etoposide 4 mg/kg/dose ≤ 12 kg or 120 mg/m2/dose > 12 kg Days 1-3 Doxorubicin 1 mg/kg/dose for patients ≤ 12 kg or 30 mg/m2/dose for patients > 12 kg Day 1 8 Cyclophosphamide 33.3 mg/kg/dose for patients ≤ 12 kg or 1000 mg/m2/dose for patients > 12 kg Day 1 Doxorubicin 1 mg/kg/dose for patients ≤ 12 kg or 30 mg/m2/dose for patients > 12 kg Day 1 Case Age (days)/gender Primary site Metastatic lesion Histology N-MYC Clinical Philadelphia* Score Chemotherapy # cycles Follow up (month) Outcome Initial prsentation At progression 1 52/M Right supra-renal Hepatic lesions Poorly differentiated NA 0 1 8 84 Alive 2 98/F Bilateral supra-renal Hepatic lesions FH NA 0 0 0 81 Alive 3 82/F Retroperi-toneal Hepatic lesions† Poorly differentiated NA 0 1 4 45 Alive 4 104/F Right supra-renal Hepatic lesions FH NA 2 2 8 41 Alive 5 114/M Retroperitoneal Hepatic lesions FH NA 0 1 8 33 Alive 6 65/F Left supra-renal Hepatic lesions FH NA 0 1 4 31 Alive ↵* Adapted from “Hepatomegaly in neuroblastoma stage 4S: criteria for treatment” by Hsu et al.7 0=asymptomatic, 1=mild/moderate, 2=severe, organ function compromise, F: female, M: male, NA: not amplified, FH: favorable histology (children younger than 18 months with a low or intermediate mitosis-karyorrhexis index; A differentiating or partially differentiating tumor and not amplified [N-MYC]).
↵† Hepatic lesion biopsy after 1st cycle of chemotherapy.