Chemotherapy of Neuroblastoma

Abstract

The treatment of neuroblastoma of childhood has long fascinated the physician and surgeon. Perhaps this is because of the vagary of the tumor. In spite of gloomy mortality figures, an appreciable number of cases have responded to some form of therapy, be it surgery, irradiation, and more recently, chemotherapy, and have survived. Moreover, cases of spontaneous remissions have been seen. This occasional happy outcome serves as a great stimulus to all concerned, but also leads to premature conclusions regarding the effectiveness of the therapeutic agent or agents being employed. Neuroblastoma represents approximately 12% of all childhood tumors, excluding the leukemias and lymphomas, 38,39 and in the not so distant past when no therapy was available, the average survival was quoted as ranging from eight weeks 39 to four months. 40 This universally hopeless picture changed considerably in 1940 when Farber 41 and Wyatt and Farber 8 published their series on