Impact of Intensified Therapy on Clinical Outcome in Infants and Children With Neuroblastoma: The St Jude Children's

To gauge the impact of intensified therapy on the survival of infants (younger than 1 year, n = 129) and children ( _ 1 year of age, n = 275) with neuroblas-toma, we analyzed the results of eight successive clinical trials comparing various combinations of anti-neoplastic drugs, surgery, and radiotherapy. Changes in treatment did not affect the survival of children with involved noncontiguous lymph nodes or distant meta-static disease until the combination of cisplatin and teniposide (CDDP/VM26) was added to a basic regi-men of cyclophosphamide and doxorubicin (CTX/ DOX). The resulting 4-year survival was 28 %-t 5 % (SE) compared with 7 %- 2 % for previous treatments (P <.001 by the log-rank test). The 4-year survival of infants with metastatic disease was improved by ad