Metastatic 4S neuroblastoma with excellent outcome in Saudi cancer center

Article Figures & Data

Table 1

- Chemotherapy schedules for symptomatic infant neuroblastoma (4S).

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
1 and 7	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
3 and 5	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
8	Doxorubicin	1 mg/kg/dose for patients ≤ 12 kg or 30 mg/m2/dose for patients > 12 kg	Day 1

Table 2

- Patient’s characteristics, treatment plan, and outcome.

Case	Age (days)/gender	Primary site	Metastatic lesion	Histology	N-MYC	Clinical Philadelphia* Score		Chemotherapy # cycles	Follow up (month)	Outcome
Case	Age (days)/gender	Primary site	Metastatic lesion	Histology	N-MYC	Initial prsentation	At progression	Chemotherapy # cycles	Follow up (month)	Outcome
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.