Response-based Treatment of High-risk Neuroblastoma
Response-based Treatment of High-risk Neuroblastoma
The purpose of this study is to improve outcome of high risk neuroblastoma by tailoring the
 treatment intensity of tandem high dose chemotherapy according to the treatment response to
 induction chemotherapy.
Although the outcome of high-risk neuroblastoma improved after the introduction of high-dose
 chemotherapy and autologous stem cell transplantation (HDCT/autoSCT), the outcome still needs
 to be unsatisfactory.

 In the investigator's previous study, good responders who had greater reduction of tumor
 volume after induction chemotherapy showed lower relapse-free survival compared to poor
 responders.Simultaneously, the reduction in tumor volume also was greater in patients who
 died of treatment related mortality than patients who had relapsed tumors. These findings
 suggest that tailoring treatment intensity according to the early tumor response to induction
 chemotherapy may improve patient outcomes. So, in this study investigators tailored the
 treatment intensity of high dose chemotherapy according to the treatment response to
 induction chemotherapy.
Inclusion Criteria:

 -  Patients with newly diagnosed high risk neuroblastoma

 -  Patients with informed consent

 Exclusion Criteria:

 -  Patients with progressive disease or relapse

 -  Patients who underwent high dose chemotherapy before

 -  Patients with organ dysfunction as follows (creatinine elevation > 3 x upper limit of
 normal, Total bilirubin > 3 x upper limit of normal, aspartate transaminase/alanine
 transaminase > 5 x upper limit of normal), ejection fraction <40%

 -  Pregnant or nursing women