Response- and Biology-Based Therapy for Intermediate-Risk Neuroblastoma

RATIONALE: Drugs used in chemotherapy, such as carboplatin, cyclophosphamide, etoposide, and
doxorubicin hydrochloride, work in different ways to stop the growth of tumor cells, either
by killing the cells or by stopping them from dividing. Isotretinoin may help neuroblastoma
cells become more like normal cells, and grow and spread more slowly. Giving combination
chemotherapy before surgery may make the tumor smaller and make it more likely that the tumor
can be surgically removed. It is not yet known what is the minimal amount of chemotherapy
needed to achieve sufficient tumor shrinkage to control intermediate risk neuroblastoma and
prevent tumor recurrence or metastases.

PURPOSE: This phase III trial is designed to reduce therapy for patients with favorable
biology intermediate risk neuroblastoma by decreasing the number of chemotherapy cycles
administered and by allowing for up to 50% residual tumor volume for patients with localized
disease.