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Treatment for recurrent/refractory neuroblastoma with venous arsenic trioxide combined with chemotherapy in 7 cases

??Objective??To summarize the efficacy and safety of arsenic trioxide combined with chemotherapy for children with recurrent/refractory neuroblastoma. Methods??Retrospective analysis was made in seven cases of neuroblastoma treated with traditional chemotherapy combined with venous arsenic trioxide after diagnosis with poor prognosis or the condition deteriorated. Results??Among the seven patients treated with chemotherapy combined with venous arsenic trioxide for 3 to 7 courses??4 were effective and 3 were ineffective. Patient 3 was treated with arsenic trioxide combined with following regimen after tumor was not resected totally??and patient 5??6 and 7 were given arsenic trioxide combined with preoperative chemotherapy. Patient 3 and patient 5 achieved complete remission after combination chemotherapy??and patient 6 and patient 7 showed decreased tumor volume and tumor marker. Patient 1??2 and 4 were given arsenic trioxide after failure of conventional chemotherapy. Metastasis in patient 1 disappeared at first??but the disease relapsed after 11 months. The tumor responded poorly and increased in size and number in patient 2 and patient 4. Patient 1 the use of arsenic trioxide was stopped in patient 1 because of prolonged QT interval??0.51s????who returned normal after symptomatic treatment. Five patients are still alive and they have lived for 3.5 y??3.0 y??1.2 y??1.0 y and 0.7 y??respectively. Conclusion??Venous arsenic trioxide combined with chemotherapy can be a choice of treatment for recurrent/refractory neuroblastoma??whose effect and safety requires further investigation.