Treatments for stage 4S neuroblastoma

Last medical review:

There is no standard treatment for stage 4S neuroblastoma, and many children may not need to have any treatment. If your child doesn't have any symptoms or unfavourable prognostic factors, they may just need watchful waiting (observation). Children with symptoms or unfavourable prognostic factors may be treated with chemotherapy. Surgery may not be necessary for stage 4S neuroblastoma other than a biopsy of the primary site or a site where the disease has spread.

Watchful waiting

Watchful waiting may be the only treatment needed for children with stage 4S neuroblastoma who don't have any symptoms. Often these tumours will disappear on their own or will turn into a non-cancerous ganglioneuroma. If symptoms develop, doctors may offer chemotherapy or other treatments available in a clinical trial.

Chemotherapy

Chemotherapy is sometimes used to treat stage 4S neuroblastoma if children have symptoms or unfavourable prognostic factors. Chemotherapy uses anticancer drugs to destroy cancer cells.

Chemotherapy drugs that may be used include:

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

Radiation therapy

Low-dose radiation therapy is sometimes, but rarely, used to treat stage 4S neuroblastoma. Radiation therapy uses high-energy rays or particles to destroy cancer cells. It may be given to treat symptoms of liver metastases.

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
  • American Society of Clinical Oncology. Neuroblastoma. 2018: https://www.cancer.net/cancer-types/neuroblastoma-childhood/view-all.
  • Lacayo NJ. Pediatric Neuroblastoma. eMedicine/Medscape; 2017: https://emedicine.medscape.com/.
  • Cancer Research UK. Neuroblastoma. Cancer Research UK; 2014.
  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Health ProfessionalVersion. Bethesda, MD: National Cancer Institute ; 2020: https://www.cancer.gov/.
  • 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: https://www.cancer.gov/types/neuroblastoma/patient/neuroblastoma-treatment-pdq.
  • American Cancer Society. Treating Neuroblastoma. 2020: https://www.cancer.org/.
  • 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.