Serial catecholamines in the radiation management of children with neuroblastoma

Abstract

Sixteen children with neuroblastoma had serial urinary determinations of vanilmandelic acid (VMA), normetanephrine (NMN), metanephrine (MN), norephinephrine (NE), epinephrine (E), and homovanillic acid (HVA). These were correlated with stage of disease, management, any maturation of tumor, and prognosis. The VMA and HVA values were most useful. Ten children with bone marrow involvement, of which seven had osseous radio-logic lesions, had an unfavorable course. Initial determinations were higher, and these values increased markedly. Five children have survived 5 to 10 years. Their values were lower and returned to normal. Serial determinations were helpful in appraising maturation of the tumor, guiding the need and dosage of radiation, the value of a second operation, and effect of chemotherapy. If treatment is to initiate maturation or regression, serial studies should provide a basis for combining therapeutic modalities.