Ultrasonography was applied to 140 pediatric patients who were diagnosed with histopathological confirmation of masses by either surgical or autopsy methods during the past nine years in the National Children's Hospital and the Hospital of Toho University. The masses were classified into three ultrasonic patterns; solid, cystic, and mixed. A solid pattern was obtained in 47 cases, a cystic pattern in 67, and a mixed pattern in 26. Of the cases of the solid pattern, a benign tumor was seen in 32 per cent, and a malignant tumor in 68 per cent. Each 50 per cent of the cases of the mixed pattern had malignant or benign tumors. All the cases of the cystic pattern had benign tumors. Ultrasonics was used as a supplement to routine clinical studies.
Purpose: To elucidate the efficacy of intensive induction and consolidation chemotherapy regimens (Study Group of Japan for Advanced Neuroblastoma [JANB] 85) for patients with advanced neuroblastoma aged 1 year or older. Patient and Methods: One hundred fifty-seven patients with newly diagnosed advanced neuroblastoma were entered into this study between January 1985 and December 1990. Eligible patients were 12 months old or older with stage III or IV disease. The patients first received six cyclic courses of intensive induction chemotherapy (designated regimen A1) consisting of cyclophosphamide (1,200 mg/m2), vincristine (1.5 mg/ m2), tetrahydro-pyranyl Adriamycin (pirarubicin; 40 mg/m2), and cisplatin (90 mg/m2). The patients were further treated with three different consolidation protocols: 3-[(4-amino-2-methyl-5-pyrimidinyl)methyl]-1 -(2-chloroethyl)-1 -nitrosourea, dacar-bazine, and bone marrow transplantation. Results: Overall survival rates for patients with stage III disease without reference to the consolidation protocols were 80.8%, 76.9%, and 66.3% at 2, 5, and 10 years, respectively. The overall survival rates for patients with stage IV disease were 58.8%, 34.4%, and 28.9% at 2, 5, and 10 years, respectively. There were no statistically significant differences between the three consolidation treatment groups. Patients who did not achieve complete remission (CR) with induction chemotherapy and surgery all died, suggesting that CR is essential for the cure of advanced neuroblastoma. The overall 5-year survival rate of the 24 patients with N-myc amplified stage III and IV disease was 33.3%, and the longest survival time of a relapse-free patient was 103 months. Conclusion: The intensive induction chemotherapy regimen used in this study may be of significant value in increasing the CR rate and survival for patients with N-myc amplified and nonamplified advanced neuroblastoma.
