J.Jpn. Surg. Soc.. 79(9): 972-977, 1978

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Report on the annual meeting

TREATMENT OF METASTATIC NEUROBLASTOMA

Forty of 50 patients (80%) with neuroblastoma has metastatic disease at the time of diagnosis. Thirty (60%) patients had stage IV disease and 10 (20%) had stage IV-S. Survival in stage IV-S was 70%. Deaths were related to respiratory insufficiency and generalized bone metastases. Lymphocyte counts (mean 6,285) and blastogenesis of the lymphocyte to PHA remained at high levels even after chemotherapy except one case in the surviving patients, but these were at low levels (mean 3,566). The regression was histologically confirmed as maturation of the neuroblastoma cells to ganglioma cells in 3 cases.
A tissue culture of the neuroblastoma tissue obtained from the 4-year-old girl was performed. Maturation was observed in the culture containing dibutyryl C-AMP and papaverine. However, maturation or remission was not recongnized in the patients with stage IV.
High dose cyclophosphamide therapy (40-80 mg/Kg) was administered for two successive days each 3 to 4 weeks to 5 patients with stage IV. The tumor regression was obtained in all of the patients and excision of the tumor became possible in 2 of them, but one died of sepsis after 3 weeks.
The level of cellular immunity was measured by PPD and PHA skin test and PHA blastogenesis of the lymphocytes among the metastatic neuroblastoma patients. They usually related to the prognosis and decreased markedly after chemotherapy and surgery. However, one patient with stage IV-S showed remission even at the low level of cellular immunity due to chemotherapy and irradiation .
The average survival time was elongated about 4 months after these treatments.

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