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Lookup NU author(s): Simon Cotterill,
Professor Louise Parker,
Emeritus Professor Alan Craft
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Background. The N7 protocol for poor-risk neuroblastoma uses dose-intensive chemotherapy (as in N6 protocol [Kushner et al.:] Clin Oncol 12:2607-2613, 1994] but with lower dosing of vincristine) for induction, surgical resection and 2100 cGy hyperfractionated radiotherapy for local control, and for consolidation, targeted radioimmunotherapy with 131I-labeled anti-GD2 3F8 monoclonal antibody and immunotherapy with unlabeled/unmodified 3F8 (400 mg/m2). Procedure. The chemotherapy consists of: cyclophosphamide 70 mg/kg/d × 2 and a 72-hr infusion of doxorubicin 75 mg/m2 plus vincristine 2 mg/m2, for courses 1, 2, 4, and 6; and cisplatin 50 mg/m2/d × 4 and etoposide 200 mg/m2/d × 3, for courses 3, 5, and 7. 131I-3F8 is dosed at 20 mCi/kg, which is myeloablative and therefore necessitates stem-cell support. Results. Of the first 24 consecutive previously untreated patients more than 1 year old at diagnosis, 22 were stage 4 and two were unresectable stage 3 with MYCN amplification. Chemotherapy achieved CR/VGPR in 21 of 24 patients. Twenty patients to date have completed treatment with 131I-3F8, and 15 patients have completed all treatment. With a median follow-up of 19 months, 18 of 24 patients remain progression-free. Conclusions. Major toxicities were grade 4 myelosuppression and mucositis during chemotherapy, and self-limited pain and urticaria during antibody treatment. Late effects include hearing deficits and hypothyroidism. © 2001 Wiley-Liss, Inc.
Author(s): Cotterill, S. J., Parker, L., More, L., Craft, A. W.
Publication type: Conference Proceedings (inc. Abstract)
Publication status: Published
Conference Name: 8th Advances in Neuroblastoma Research Conference (1998)
Year of Conference: 2001
Publisher: Medical and Pediatric Oncology: John Wiley & Sons, Inc.
PubMed id: 11464891