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Event-Free Survival of Patients With High-Risk Neuroblastoma Treated With an N6-Like Induction Treatment

For the Neuroblastoma Group of the Société Française d'Oncologie Pédiatrique, Département de Pédiatrie, Institut Gustave Roussy, Villejuif, France

To the Editor:

Kushner et al¹ presented the results of three successive induction protocols (N6, N7, N8) with the same basic chemotherapy regimen, including high-dose cyclophosphamide plus doxorubicin/vincristine and high-dose cisplatin/etoposide. The complete response rate of metastases for the entire cohort of patients with a stage 4 neuroblastoma is very high at 87%. It is significantly higher than that obtained by the Société Française d'Oncologie Pédiatrique (SFOP) neuroblastoma group of 47 patients treated according to the N7 protocol.² In this cohort of patients, 21 children (45%; 95% CI, 30% to 60%) achieved complete response of metastases at the end of induction chemotherapy. As planned by the protocol, high-dose chemotherapy combining busulfan (600 mg/m²) and melphalan (140 mg/m²) was administered to 39 of 47 patients. The 4-year event-free survival rate (EFS) for the whole cohort was 38% (range, 26% to 53%). Interestingly, patients with complete response of metastases at the end of induction chemotherapy had a significantly better outcome than the 26 of 47 patients who did not achieve complete response of metastases, with a 4-year-EFS of 57% (95% CI, 37% to 76%) and 23% (95% CI, 11% to 42%), respectively (P = .04). It would be necessary to know the EFS of the Memorial Sloan-Kettering Cancer Center (New York, NY) cohort, as their first patients have a very long follow-up since they were enrolled onto this study in 1990. This should shed light on the impact the very high complete response rate of metastases obtained at this institution has on survival.

Author's Disclosures of Potential Conflicts of Interest

The author indicated no potential conflicts of interest.

REFERENCES

1. Kushner BH, Kramer K, LaQuaglia MP, et al: Reduction from seven to five cycles of intensive induction chemotherapy in children with high-risk neuroblastoma. J Clin Oncol 22:4888-4892, 2004[Abstract/Free Full Text]

2. Valteau-Couanet D, Michon J, Boneu A, et al: Induction chemotherapy in children older than 1 year with Stage 4 neuroblastoma treated with the NB 97 French Society of Pediatric Oncology Protocol. J Clin Oncol 23:532-540, 2005[Abstract/Free Full Text]

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Related Reply

• In Reply:
  Brian H. Kushner, Kim Kramer, Michael P. Laquaglia, Shakeel Modak, Karima Yataghene, and Nai-Kong V. Cheung
  JCO 2005 23: 6263 [Full Text]

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Valteau-Couanet, D. Search for Related Content PubMed PubMed Citation Articles by Valteau-Couanet, D. Related Articles Related Reply Social Bookmarking                            What's this?