n HOW IS NEUROBLASTOMA TREATED? Your child’s treatment for neuroblastoma will be based on their staging and risk group: low risk, intermediate risk, or high risk.
For infants with low-risk neuroblastoma, whose disease has not spread to the bone, the tumor sometimes breaks down on its own. In these instances, your healthcare team may observe your child closely without treatment. Neuroblastoma that consists of a single tumor or mass (low risk) that can be removed totally with surgery may not require further treatment. Intermediate-risk neuroblastoma may be treated by surgical removal of the tumor with or without moderate doses of chemotherapy. High-risk neuroblastoma most often is treated with a combination of chemotherapy, surgery, high-dose chemotherapy with peripheral blood stem cell rescue (often referred to as a stem cell transplant), radiation therapy, immunotherapy, retinoic acid, and possibly targeted radionuclides (MIBG therapy). Your healthcare team will speak to you in detail about your child’s expected treatment course. Surgery Surgery to remove the tumor usually is only done at the time of diagnosis in low-risk neuroblastoma that will not require further treatment. In high-risk neuroblastoma, the complete or partial removal of the tumor through surgery is more successful after the tumor has been shrunk by chemotherapy. Using chemotherapy first minimizes the risk during surgery of injuring normal organs that the neuroblastoma may be attached to. Chemotherapy Most children with neuroblastoma will receive chemotherapy (anticancer drugs), which involves giving specific drugs to kill cancer cells. Several chemotherapy medications are known to be effective in killing neuroblastoma cells. Cyclophosphamide, topotecan, doxorubicin, vincristine, cisplatin, and etoposide are the agents most commonly used in induction (the initial phase of treatment that aggressively tries to get rid of the disease). Other agents that may be used to treat neuroblastoma include ifosfamide, carboplatin, irinotecan, temozolomide, and several others. No single drug can control this disease by itself, so the drugs are given in a special combination, most often into a vein through a venous access device (VAD), which was discussed earlier in this booklet. Each treatment lasts several days and is usually given in the hospital or a clinic. When chemotherapy is needed, close monitoring of your child will be a priority. Possible side effects of the specific chemotherapy your child requires will be explained to you in detail by your child’s healthcare team.
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