Treatments for intermediate-risk neuroblastoma

Last medical review:

The following are treatment options for intermediate-risk neuroblastoma. The healthcare team will suggest treatments based on your child's needs and work with you to develop a treatment plan.

Treatments for intermediate-risk neuroblastoma may include:

  • chemotherapy with or without surgery
  • surgery alone (in babies)
  • radiation therapy (to relieve serious symptoms, if other treatments don't work)


Chemotherapy is the main treatment for intermediate-risk neuroblastoma. Chemotherapy uses anticancer drugs to destroy cancer cells. It may be given before or after surgery. Chemotherapy may be given before surgery to shrink the tumour and make it easier to remove. It may be given after surgery to treat any tumour that was left behind.

A combination of chemotherapy drugs is often given for 4 to 8 cycles (12 to 24 weeks). The most common drugs used are:

  • carboplatin or cisplatin
  • cyclophosphamide
  • doxorubicin
  • etoposide
Find out more about chemotherapy for neuroblastoma.


Surgery is often used to remove as much of the neuroblastoma as possible. It may be used before or after chemotherapy. If surgery is done before chemotherapy, a second-look surgery may be done again after chemotherapy to see if there is any cancer left and to remove it, if possible.

For infants who have no symptoms, surgery may be the only treatment used for intermediate-risk neuroblastoma. It is followed by watchful waiting (observation).

Find out more about surgery for neuroblastoma.

Radiation therapy

Radiation therapy is not commonly used to treat intermediate-risk neuroblastoma. Radiation therapy uses high-energy rays or particles to destroy cancer cells. It may be used to treat children with neuroblastoma that grows or spreads during chemotherapy or can't be removed after chemotherapy. It may be used to treat a tumour that is causing serious symptoms if they are not relieved with other therapies. These symptoms include spinal cord compression (if the tumour is pressing on the spine) or difficulty breathing (if the liver is enlarged and crowding the lungs).

Find out more about radiation therapy for neuroblastoma.

Clinical trials

Children with cancer may be treated in a clinical trial. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • Meredith Irwin, MD
  • Daniel Morgenstern, MD
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  • Lacayo NJ. Pediatric Neuroblastoma. eMedicine/Medscape; 2017:
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  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Health ProfessionalVersion. Bethesda, MD: National Cancer Institute ; 2020:
  • Brodeur GM, Hogarty MD, Bagatell R, Mosse YP, Maris JM. Neuroblastoma. Pizzo PA, Poplack DG, eds.. Principles and Practice of Pediatric Oncology . 7th ed. Philadelphia, PA: Wolters Kluwer; 2016: 30:772–797.
  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Patient Version. Bethesda, MD: National Cancer Institute; 2021:
  • American Cancer Society. Treating Neuroblastoma. 2020:
  • Bartholomew, J . Neuroblastoma. Baggott C, Fochtman D, Foley GV & Patterson Kelly, K (eds.). Nursing Care of Children and Adolescents with Cancer and Blood Disorders. 4th ed. APHON; 2011: 30: pp. 1038-1053.
  • Lacayo NJ. Medscape: Pediatric Neuroblastoma Treatment and Management. WebMD LLC; 2012.