神経芽細胞腫マススクリーニングで発見された乳児例の治療について

概要

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Twenty-seven patients with neuroblastoma discovered by a mass screening program for infants in Kyoto, Japan, during the 16-year period from 1972 to 1988, have been treated at our hospital. All patients were diagnosed as having a neuroblastoma before 9 month of age and were classified as follows '. 1 patients in stage I, 6 in stage II, 5 in stage IVs, 2 in stage III, and 7 in stage IV. All patients received surgery for removal of a primary tumor mass and chemotherapy. The initial 3 patients in this program received radiotherapy. Twenty two patients were treated by intravenous vincristine (VCR) and cyclophosphamide (CPM) administration for 6 months followed by oral CPM administration for 6-12 months. Four of the remaining 5 patients were in stage IV and were treated intensively by a combination of drugs such as VCR, CPM, THP-ADR, and CDDP. Twenty-six patients (96%) are alive now. One patient with stage IV diseses relapsed and died following the progress of disease. As a result, we suggest that for patients in stage I, II, IVs, chemotherapy of a combination of VCR and CPM intravenously for 6 months is satisfactory. However, for patients with stage IV, disease more intensive chemotherapy such as a combination of VCR, CPM, THP-ADR, and CDDP is more effective. The necessity for oral CPM administration is discussed.
日本小児外科学会の論文
1990-06-20