Treatments for neuroblastoma

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If your child has neuroblastoma, the healthcare team will create a treatment plan just for your child. It will be based on your child's health and specific information about the cancer. When deciding which treatments to offer for neuroblastoma, your child's healthcare team will consider:

  • your child’s age
  • the stage (size and location of neuroblastoma and whether it has spread)
  • the risk group
  • your child's overall health
Surgery is the main treatment for neuroblastoma that has not spread. Chemotherapy is often used to treat neuroblastoma. Other treatments may also be used, including radiation therapy, retinoids, immunotherapy, stem cell tranplant and targeted therapy.

Doctors will closely monitor the child’s response to treatment to decide if treatment should continue, if treatment can be stopped or if they should try other treatments.

Response to treatment

Knowing how well neuroblastoma responds to treatment helps doctors decide whether or not treatment can be stopped or more treatment is needed. Response to treatment is monitored using imaging tests. MIBG and PET scans are used for measuring the primary tumour and any spread to bone, bone marrow, lymph node or soft tissue. Doctors use the following criteria to measure the response to treatment.

Complete response means that there is no evidence of disease by MIBG or PET scan in any location of soft tissue or bone, with less than 10 mm at largest diameter of primary tumour, less than 10 mm at largest diameter of target lymph nodes and no tumour in 2 bone marrow biopsies and 2 bone marrow aspirations.

Partial response means that all tumours are over 30% smaller than before treatment, there are no new metastases and an MIBG or PET scan showed at least a 50% reduction in bone metastases.

Stable disease means that some tumours may have shrunk, but by less than 30% of their original size, or the MIBG or PET scan may have improved but by less than a 50% reduction in score. This group also includes patients where there is no apparent response to treatment at all.

Progressive disease means that there is a new tumour or new spots on an MIBG scan, a tumour has grown by at least 20%, or there are cancer cells in the bone marrow that were not there before treatment.

Treatments for low-risk neuroblastoma

Low-risk neuroblastoma can be treated with surgery, chemotherapy and radiation therapy.

Treatments for intermediate-risk neuroblastoma

Intermediate-risk neuroblastoma can be treated with chemotherapy, surgery and radiation therapy.

Treatments for high-risk neuroblastoma

High-risk neuroblastoma can be treated with chemotherapy, surgery, stem cell transplant, radiation, retinoids and immunotherapy.

Treatments for stage 4S neuroblastoma

There is no standard treatment for stage 4S neuroblastoma. Many children may not need to have any treatment.

Treatments for recurrent neuroblastoma

Recurrent neuroblastoma treatment is based on the risk group given to the cancer when it was first diagnosed.

Surgery for neuroblastoma

Surgery is a medical procedure to examine, remove or repair tissue. Neuroblastoma is often treated with surgery.

Chemotherapy for neuroblastoma

Chemotherapy uses anticancer drugs to destroy cancer cells. Neuroblastoma is often treated with chemotherapy.

Radiation therapy for neuroblastoma

Radiation therapy uses high-energy rays to destroy cancer cells. It may be used to treat neuroblastoma.

Retinoids and immunotherapy

Retinoids and immunotherapy are sometimes used to treat high-risk or recurrent neuroblastoma.

High-dose chemotherapy and stem cell rescue for neuroblastoma

A stem cell rescue (transplant) replaces stem cells. Neuroblastoma is sometimes treated with high-dose chemotherapy and stem cell rescue.

Targeted therapy for neuroblastoma

Targeted therapy uses drugs to target specific molecules on cancer cells. Neuroblastoma is sometimes treated with targeted therapy.

Watchful waiting for neuroblastoma

Watchful waiting may be offered for neuroblastoma. The healthcare team watches the cancer closely to see if it is growing before offering other treatments.

Follow-up after treatment for neuroblastoma

Follow-up is an important part of care for neuroblastoma. It often involves regular tests and visits with the healthcare team.

Late effects for neuroblastoma

Recovering from and adjusting to life after treatment for neuroblastoma is different for each child. Recovery depends on many factors. Learn about the late effects for neuroblastoma.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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