進行性神経芽細胞腫の集学的治療

概要

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Three patients with advanced neuroblastoma were treated with a multimodal therapy, which protocol consist of chemotherapy, delayed primary operation, intraoperative irradiation and autologus bone marrow transplantation (ABMT). High dose cyclophosphamide, THP-adriamycin, vincristine and cisdiamminedi-chloroplatinum were administered as chemotherapeutic agents, and high dose L-phenylalanine mustard (L-PAM) as preconditioning of ABMT. 1) This protocol of chemotherapy was found to be very effective in spite of severe bone marrow suppression. 2) Serum neuron-specific enolase (NSE) is useful in the decision of the timing when the operation and ABMT should be performed. 3) Intraoperative irradiation is effective, especially in infants and children. 4) It is very important to keep good renal function in order to carry out this protocol. 5) ABMT is very useful because up to 10 times of conventional doses of chemotherapeutic agents, for example, high dose L-PAM 180mg/m^2 can be administered. 6) Moderate chemotherapy should be continued during 2 years after ABMT. We cannot conclude the result of our treatment because the maximum follow-up period is 2 years 4 months, but all of three patients are in disease-free condition now.
日本小児外科学会の論文
1988-06-20