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Treatment Complications in Children Diagnosed With Neuroblastoma During a Screening Program

Stéphane Barrette, Mark L. Bernstein, Jean-Marie Leclerc, Martin A. Champagne, Yvan Samson, Josée Brossard, William G. Woods

From the Hôpital Ste-Justine and Montreal Children's Hospital, Montréal; Centre Hospitalier de l'Université Laval, Ste-Foy; Centre Universitaire de Santé de l'Estrie, Sherbrooke, Québec, Canada; AFLAC Cancer Center, Emory University and Children's Healthcare of Atlanta, Atlanta, GA

Address reprint requests to Stéphane Barrette, 3175 Côte Ste-Catherine, Bureau 3415, Montréal, Québec, Canada, H3T 1C5; e-mail: stephane.barrette{at}umontreal.ca

PURPOSE: The Québec Neuroblastoma Screening Program was put in place to investigate the possibility of decreasing mortality from high-risk neuroblastoma through early screening. We assess treatment complications in the patients diagnosed during this screening program.

PATIENTS AND METHODS: A total of 476,603 patients born during the screening period were eligible. Parents of 425,838 children (89%) agreed to participate in the 3-week screening, and 73% agreed to participate in the 6-month screening. Forty-five patients had neuroblastoma. We reviewed the medical and research charts for all patients diagnosed by screening. Follow-up was available from 8 to 13 years after screening.

RESULTS: Forty-five patients were diagnosed by screening. All patients were treated according to the Pediatric Oncology Group recommendations of the time. All patients had surgery, and 29 patients received chemotherapy. No patient died from neuroblastoma. Eleven patients suffered complications from treatment. Two patients had life-threatening complications.

CONCLUSION: In view of the lack of impact of screening programs on neuroblastoma mortality, evidence that many of the tumors detected through screening can be observed without treatment and the serious complications that may arise from therapy, we do not support neuroblastoma screening programs for children.

Supported by Grant No. CA46907 from the National Institutes of Health.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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