Stage III, IV 神経芽細胞腫の Combined Modality Therapy : その治療成績と問題点

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Since April, 1976, advanced neuroblastoma has been treated with combined modality therapy including immunotherapy and intravenous hyperalimentation at our department. Three-drug combination chemotherapy consisting adriamycin, vincristine and cyclophosphamide was given as initial chemotherapy. Refractory cases were treated with high dose cyclophosphamide, DTIC, DDP and papaverine. Immunotherapy with BCG-CWS or Nocardia-CWS has been administered in their maintenance phase. Intravenous hyperalimentation was used during intensive chemotherapy. 10 neuroblastoma children with stage III and IV received this therapy. Meidian survival time of these children was 14 months and this was much longer than 4 months which derived from neuroblastoma children who were mainly treated with James' therapy in addition to surgery and irradiation before April, 1976. Among multiple anticancer drugs, adriamycin, high dose cyclophosphamide and DDP seemed to contribute to improved survival time. Intravenous hyperalimentation was useful for preventing malnutritional state. From these results we are now trying to establish new protocol for initial and maintenance treatment of advanced neuroblastoma.
日本小児外科学会の論文