PEDIATRICS Vol. 41 No. 2 February 1968, pp. 452-462
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TREATMENT OF MALIGNANT SYMPATHETIC TUMORS IN CHILDREN: CLINICOPATHOLOGICAL CORRELATION

Carlos A. Perez M.D.1, Teresa J. Vietti M.D.1, Lauren V. Ackerman M.D.1, Panja Kulapongs M.D.1, and William E. Powers M.D.1

1 E. Mallinckrodt Institute of Radiology and the Departments of Pediatrics and Surgical Pathology, Washington University School of Medicine, St. Louis

The results of treatment in a series of 46 children with malignant sympathetic tumors are reported with an absolute cure rate of 47% at 2 years and 46% at 5 years. Thirty-two percent of the patients with distant metastasis have survived tumor free 2 years or longer.

Factors affecting the prognosis and the various methods of treatment are analyzed. Aggressive radiation therapy of these patients is advocated, depending on their clinical condition, even in the presence of distant metastasis. The primary role of irradiation in the sterilization of these malignant sympathetic tumors is postulated. Chemotherapy with cyclophosphamide and vincristine produced only transient regression of some of the tumors, with limited palliative results. The indication of chemotherapeutic agents is questioned in the treatment of patients with localized tumor because it is felt that this may impair the host resistance of the patient. Intensive chemotherapy may adversely affect survival, although admittedly all patients receiving this form of therapy had far advanced disease.

Submitted on May 26, 1967
Accepted on August 21, 1967