The role of multimodal therapy in patients with local and regional neuroblastoma

The records of 49 patients with local and regional neuroblastoma treated at The Children's Hospital of Philadelphia between 1972-1981 were reviewed to determine the contribution of radiation therapy and chemotherapy to their management. All 11 state I patients were treated with surgery alone and 10 (91%) survived for periods ranging from 3 to 10 years. Half of the 24 stage II patients received radiation therapy with or without chemotherapy and 8/12 (67%) survive. Ten of the 12 remaining stage II patients survive (83%) following surgery alone. All stage II patients had residual disease and 13 had involvement in lymph nodes. 7 in the combined treatment group and 6 in the surgery alone group. All 14 stage III patients received postoperative chemotherapy and radiation therapy (RT) and 7 or 50% remain disease free. We conclude that surgery alone is sufficient for patients with stage I NBL, that RT and chemotherapy do not appear to alter the outcome in stage II patients, and better methods of therapy are needed for patients with stage III disease.