There has been a striking improvement in the overall numbers of children and adolescents who become disease-free and remain disease-free as a result of intensive therapy as defined today, for the following cancers: acute nonlymphocytic leukemia (ANLL), non-Hodgkin's lymphoma (NHL), poor risk acute lymphocytic leukemia (ALL), osteosarcoma, and Ewing's sarcoma. The therapy for each of these tumors, with the exception of osteosarcoma, consisted of combination cheqotherapy with or without radiotherapy and was started as soon after diagnosis as possible. Aggressive thfrapy of osteosarcoma has consisted of surgical removal of lung metastases and chemotherapy. Intensive chemotherapy recently has included the use of high doses of certain drugs such as cytosine arabinoside (Ara-C), methotrexate, VP-16-213 and melphalan in the treatment of patients with tumors that are currently difficult to treat.
Cancer 58:481-487. 1986. NTENSIVE THERAPY for treatment of cancer was first I introduced in the late 1960s for the treatment of acute lymphocytic leukemia (ALL) in children and Hodgkin's disease in adults. George and co-workers used vincristine and prednisone to induce a complete remission, various combinations of cyclophosphamide, methotrexate, and mercaptopurine for maintenance and craniospinal irradiation or cranial irradiation and intrathecal methotrexate for central nervous system (CNS) prophylaxis. ' Using this therapy, investigators, for the first time, began talking about cures in patients with leukemia.2 At about the same time DeVita and Serpick established that cures could be induced in patients with advanced Hodglun's disease with combination chemotherapy consisting of nitrogen mustard, vincristine, procarbazine, and predni~one.~ Both of these groups of investigators established that full doses of individual drugs were essential for best results. The treatment outlined for leukemia and Hodgkin's disease in the 1960s is today considered standard therapy and not intensive therapy.
Intensive chemotherapy, as we understand it today, was first introduced when cytosine arabinoside (Ara-C) and daunorubicin were used as inducing agents for patients with acute nonlymphocytic leukemia (ANLL).435 It was recognized in these patients that, in order to obtain a *