Treatment of localised resectable neuroblastoma. Results of the LNESG1 study by the SIOP Europe Neuroblastoma Group.

Main objective of this study was to confirm that surgery alone is an effective and safe treatment for localised resectable neuroblastoma except stage 2 with amplified MYCN gene (MYCNA). Of 427 eligible stages 1-2 patients, 411 had normal MYCN and 16 had MYCNA. Of the 288 stage 1 patients with normal MYCN, 1 died of complications and 16 relapsed, 2 of whom died; 5-year relapse-free survival (RFS) and overall survival (OS) rates were 94.3% (95% confidence interval (CI): 91.6-97) and 98.9% (95% CI: 97.7-100), respectively. Of the 123 stage 2 patients with normal MYCN, 1 died of sepsis and 22 relapsed, 8 of whom died (RFS 82.8%, 95% CI: 76.2-89.5; OS 93.2%, 95% CI: 88.7-97.8). In stage 2, OS and RFS were worse for patients with elevated LDH and unfavourable histopathology. Of 16 children with MYCNA, 7 were stage 1 (5 relapses and 4 deaths) and 9 were stage 2 (3 relapses and 2 deaths) patients. In conclusion, surgery alone yielded excellent OS for both stage 1 and 2 neuroblastoma without MYCNA, although stage 2 patients with unfavourable histopathology and elevated LDH suffered a high number of relapses. Both stage 1 and 2 patients with MYCNA were at greater risk of relapse.

[Acute lymphoblastic leukemia in childhood. A 10-year experience with the DFCI 81-01 protocol]. / Leucemia linfoblástica aguda na criança. Experiência de dez anos com o protocolo DFCI 81-01.

Acute lymphoblastic leukemia is the most frequently encountered pediatric cancer. Approximately 70% of cases can be cured of the disease. In this article, we describe the experience of our Center in the last ten years with a treatment protocol adapted from protocol DFCI 81-01 (from the Dana Farber Cancer Institute, Boston). We conclude that it is easily accomplished, well tolerated and that it allowed us to significantly improve the outcome of our patients (80% 5 year-survival). Nevertheless, we are currently in the process of changing to a new protocol--one that will hopefully achieve a comparable cure rate with less long-term toxicity.