Problems In The Prognosis Of Neuroblastoma

Abstract

The author has collected a series of 58 children with neuroblastoma in whom no active treatment was undertaken, but it should be stressed that all these cases have been histologically confirmed, either by means of biopsy or at autopsy. The average survival period of the untreated fatal cases was four months from symptomatic onset. Among the 58 untreated children included, no less than 20 showed a symptomatic onset of the illness in the first year of life, and 19 of these succumbed to the disease, as did all the ones aged more than 1 year. The one solitary survivor in the untreated series is the only instance of spontaneous regression in our series. In November 1950, a new treatment was introduced, Vitamin B12 injections. A completely unselected series of 82 patients with neuroblastoma was given this treatment. Of these, 33 children have been complete clinical failures; 8 children have shown temporary improvement; 8 more were excluded because the length of treament was considered to be inadequate. Thirty-two children have been classified as clinical remissions; 30 of them are alive, 28 for periods of from more than 2 years to 12 years. Two children have died after Vitamin B12 therapy from other causes, with no evidence of tumor at autopsy.