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Query: UMLS:C0027819 (
neuroblastoma
)
27,800
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The Spanish
Neuroblastoma
Study Group has conducted a study on advanced
neuroblastoma
(N-I-87), which included 33 stage III and 60 stage IV
neuroblastoma
children more than 1 year of age, enrolled between October 1987 and April 1992. They were staged according to
Evans
and treated with induction chemotherapy (IC) consisting of 3 courses of cyclophosphamide-doxorubicin alternating with 3 of high-dose cisplatin-teniposide. Evaluation after IC and surgery demonstrated an overall response rate of 88% for stage III and 69% for stage IV. In the latter, complete responses and good partial responses were 33 and 14%, respectively. After surgery, children received maintenance chemotherapy (all stage III except 2 and 30 stage IV) or autologous bone marrow transplantation (ABMT) (11 stage IV), the distribution was not randomised. Probability of survival at 5 years was 0.60 +/- 0.12 for stage III and 0.24 +/- 0.07 for stage IV. A significant difference in survival at 5 years was found between "good responders" and "non-responders" to initial chemotherapy.
...
PMID:The treatment of advanced neuroblastoma. Results of the Spanish Neuroblastoma Study Group (SNSG) studies. 757 86
Although precise anatomic staging is prognostically important in
neuroblastoma
, most widely employed staging systems remain incompatible. The International
Neuroblastoma
Staging System (INSS) was formulated to incorporate the basic elements of several systems to and define the significance of tumor resectability, anatomic "midline," and lymph node involvement. The authors sought to determine the applicability and value of the INSS compared with the classic
Evans
system. Between 1980 and 1992, 424 children with the diagnosis of local or regional neuroblastoma were entered in Childrens Cancer Group (CCG) clinical trials. The patients were assigned to
Evans
stage I, II, or III, by clinical and surgicopathologic assessment, and were treated uniformly by Group-wide therapy protocols. INSS stage 1, 2A, 2B, or 3, was applied, by retrospective analysis, to the children in the earlier studies, and by prospective evaluation of recent patients in the current studies. Survival and relapse-free survival (RFS) rates were determined and compared, based on age at diagnosis, extent of resection, and staging reassignment. All 87
Evans
stage I patients were classified as INSS stage 1 and had a 92% 3-year RFS rate. Of the 144
Evans
stage II patients, 65 also qualified as INSS stage 1 patients, with an 82% RFS rate. The other 79 stage II children remained in INSS stage 2A or 2B and had a 70% RFS rate (P = .10). Of the 193
Evans
stage III patients, 24 were reassigned to INSS stage 1 (85% RFS rate) and 33 to stage 2A or 2B (65% survival rate; 61% RFS rate).(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Surgical management and outcome of locoregional neuroblastoma: comparison of the Childrens Cancer Group and the international staging systems. 773 53
The observed response to 131I-metaiodobenzylguanidine (MIBG) therapy in advanced
neuroblastoma
after conventional therapy, the non-invasiveness of the procedure, and the high metabolic activity which is frequently observed in untreated tumours led to the concept of substituting 131I-MIBG therapy for combination chemotherapy at diagnosis prior to surgery in patients with advanced disease/high-risk
neuroblastoma
. The objective of introducing 131I-MIBG therapy as the first therapy in the treatment schedule is to reduce the tumour volume, enabling adequate (> 95%) surgical resection of the tumour and to avoid toxicity and the induction of early drug resistance. The advantages of this approach are that the child's general condition is unaffected or improved before it undergoes surgical resection and that chemotherapy is reserved to treat minimal residual disease postoperatively. Thirty-one children who presented with inoperable
neuroblastoma
(10
Evans
stage III, 21 stage IV) were treated according to this protocol. The objective response to the 131I-MIBG therapy at diagnosis with respect to the volume of the primary tumour, the metastases and catecholamine excretion in urine varied from 72 to 81%, which is better than after conventional treatment. Nineteen of 27 evaluable patients (70%) had complete or > 95% resection of the primary tumour or did not require surgery at all. Only 11 of 31 patients developed isolated thrombocytopenia and, despite the fact that the bone marrow was invaded in 16 patients, moderate bone marrow depression occurred in only two cases.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:131I-MIBG as a first-line treatment in high-risk neuroblastoma patients. 781 84
A retrospective multicentric study of 23 patients with stage IV-S
neuroblastoma
treated in 10 national Pediatric Surgery Departments between January 1988 and December 1992, is presented. All cases were classified as stage IV-S following staging criteria proposed by
Evans
et al. The age diagnosis was an average of 3 months. An acute clinical course was seen in 7 patients. Primary sites of the tumor were: adrenal gland in 6 patients (30.5%), abdominal paravertebral in 3 (13%) and unknown in 2 (9%). Distant tumor sites were: liver in 20 patients, bone marrow in 9, and skin in 5. There were not systematic therapeutic approach, in 16 cases (69%) the primary tumor was resected, 18 (78%) received chemotherapy, the liver was irradiated in 3 (13%), and 1 case (4%) received no treatment at all. One children died. The overall disease-free survival is 95.6% at 43 months post-diagnosis. A common treatment protocol is proposed, with systematic determination of N-myc oncogene which will indicate the appropriate therapy.
...
PMID:[Neuroblastoma IV-S. A multicenter study. Work Group of Pediatric Oncology. Spanish Society of Pediatric Surgery]. 786 60
From October 87 to April 92, 172 children were admitted in the N-I-87 protocol of the Spanish Society of Pediatric Oncology for the diagnosis and treatment of
neuroblastoma
. Forty-eight were considered
Evans
stage III, 33 of them being older than 1 year. All children were treated with induction chemotherapy (IC) and surgery. IC consisted of three courses of high-dose cisplatin-VM-26 alternating with three further courses of cyclophosphamide-doxorubicin (CAD). Infants less than 1 year received the same drugs at lower doses. After surgery, maintenance chemotherapy was administered to all children during 14 months. It consisted of four pairs of drugs rotated every 4 weeks. Radiotherapy was administered exclusively to patients older than 1 year with residual tumor after IC and surgery. Response was evaluated after IC and surgery. In children older than 1 year, response was obtained in 28/33 (88%). Fifteen of them (47%) achieved complete remission (CR), seven (22%) good partial response (GPR), six (19%) partial response (PR); and in three patients (9%) there was progressive disease (PD). Actuarial survival at 48 months was 0.60 +/- 0.10 and EFS was 0.61 +/- 0.12. Audiologic impairment was considered the worst toxicity. In children less than 1 year the response rate to IC and surgery was 93% (14/15); nine infants obtained complete response and four had GPR. Only one patient experienced PD in the first 6 months of therapy and died. The other 14 are alive and well at a mean follow-up time of 48 months. Chemotherapy toxicity was mild and reversible.
...
PMID:Treatment of stage III neuroblastoma with emphasis on intensive induction chemotherapy: a report from the Neuroblastoma Group of the Spanish Society of Pediatric Oncology. 796 89
As previously reported by this laboratory, an endogenous factor capable of inhibiting the specific binding of the radiolabeled cannabinoid agonist [3H]CP-55940 to its receptor can be released from nerve terminals in response to an influx of Ca++ induced by an ionophore (
Evans
et al., 1992). In the present report, we provide evidence that the endogenous ligand for the cannabinoid receptor can be released in response to a depolarizing stimulus (75 mM K+) in the presence of extracellular Ca++. K(+)-evoked release was not observed in the absence of extra-cellular Ca++ and was reduced by the specific calcium channel blockers verapamil and omega-conotoxin. The efflux of cannabinoid receptor binding activity is greatest within 2 min of stimulation with the Ca++ ionophore A23187. Within this period of time, the cannabinoid receptor binding activity was enhanced by the presence of a cocktail of peptidase inhibitors. Examination of the contribution of individual inhibitors for enhancing high K(+)-released material revealed a selectivity for captopril and thiorphan. The specificity of the released factor for the cannabinoid receptor was corroborated by its ability to compete with the aminoalkylindole radioligand [3H]WIN-55212 for binding to this receptor. Fractions from a semi-purified sample of the effluent demonstrated binding to the cannabinoid receptor and behaved as agonists in that these fractions could inhibit adenylate cyclase activity in
neuroblastoma
membrane preparations.
...
PMID:Endogenous cannabinoid receptor binding activity released from rat brain slices by depolarization. 813 40
Obstetrical sonography has helped diagnose and define the features of some congenital malformations and tumors. We present five fetal neuroblastomas detected by routine prenatal sonography. All were adrenal tumors diagnosed between 26 and 39 weeks gestation. All 5 tumors were completely resected postnatally and the patients have remained disease free from 2 months to 10 years after resection without adjuvant therapy. A literature review collated 16 other cases of fetal
neuroblastoma
detected by sonography between 29 and 38 weeks gestation. These cases included 1 cervical, 1 thoracic, and 14 adrenal tumors. Thirteen neonates had
Evans
stage I or II tumors, and three had more advanced disease. Eleven mothers did not have hypertension or preeclampsia during the pregnancy, and the neonates all had stage I or II disease. Four mothers had hypertension or preeclampsia. Three of these neonates had stage IV or IVS disease with liver metastases, and all three had fetal hydrops. Review of the congenital
neuroblastoma
literature documented 71 cases diagnosed soon after birth, and several of these cases had unusual features that could have been detected by prenatal ultrasound. Four of the tumors were so large that dystocia resulted and fetal dismemberment was required for delivery. Eight of the tumors metastasized to the placenta, and 1 metastasized to the umbilical cord with subsequent fetal death. We conclude that fetal
neuroblastoma
can be diagnosed by prenatal sonography. Accurate staging is difficult by sonography, but in mothers with no preeclampsia symptoms the chance of widely disseminated disease is small.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Fetal neuroblastoma: prenatal diagnosis and natural history. 830 85
The optimum time for a surgical resection of the primary lesion in the advanced
neuroblastoma
has not been defined properly. Recently the therapeutic results of the advanced
neuroblastoma
have improved through the use of preoperative chemotherapy. We check on our patients who were affected by this disease in the last 15 years. From 185 malignant tumours diagnosed in our department, 52 belonged to neuroblastomas with more than 12 months of evolution. Most of them were diagnosed during the year after their birth and it was not observed a difference of sexes. The location was the habitual one, except 2 cases of thoracoabdominal tumour and 1 of stesioneuroblastoma the most common manifestation was the metastatic disease. Catecholamines in 24 hours urine were positive in 74% of our patients, and enolase in 100% of the same ones. The longest percentage of patients is distributed in the advanced stages of
Evans
.
...
PMID:[Neuroblastoma in childhood. Review of clinical aspects and of 2 forms of treatment]. 835 22
The delta opiate receptor gene has been cloned from the mouse
neuroblastoma
-rat glioma hybrid cell NG108-15. The clone that we isolated is apparently identical to that reported by
Evans
et al. [
Evans
, C. J., Keith, D. E., Jr., Morrison, H., Magendzo, K. & Edwards, R. H. (1992) Science 258, 1952-1955] and essentially identical with that of Kieffer et al. [Kieffer, B. L., Befort, K., Gaveriaux-Ruff, C. & Hirth, C. G. (1992) Proc. Natl. Acad. Sci. USA 89, 12048-12052]. We have found full-length transcripts of the gene in mouse brain but in no other tissues examined. Within the brain the gene is expressed at low levels in many regions but transcripts are found in particularly large amounts in the anterior pituitary and pineal glands. Since these tissues are located outside the blood-brain barrier, opioid peptides easily can reach receptors in these areas from the blood. The gene, which is present as a single copy, has been mapped to the distal region of mouse Chromosome 4.
...
PMID:Regional expression and chromosomal localization of the delta opiate receptor gene. 841 97
Flow cytometric DNA analysis was performed on 45 neuroblastomas in order to evaluate the prognostic significance of DNA ploidy. The DNA ploidy was diploid in 14 and aneuploid in 31 neuroblastomas and did not correlate with the conventional prognostic variables such as age,
Evans
' stage, or the primary site of the tumor. The survival of 31 patients with aneuploid tumors was comparable to that of 14 patients with diploid tumors. On the other hand, DNA aneuploidy was associated with a decreased long-term survival in 21 patients older than 24 months of age at the time of operation, and in 27 patients with advanced disease at
Evans
' stage III or IV. These results suggest that more intensive and longer-term postoperative chemotherapy is necessary for
neuroblastoma
patients older than 24 months of age, or for those with advanced disease if they have aneuploid tumors.
...
PMID:The prognostic significance of DNA ploidy for neuroblastoma. 846 72
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