Neuroblastoma is a malignant tumor that develops from immature nerve cells of the sympathetic nervous system. It is one of the most common childhood cancers and is most often diagnosed in children under the age of 5. The tumor can arise in various parts of the body, but it is most commonly found in the adrenal glands, the abdominal cavity, the chest, the neck, or along the spine.
Treatment of neuroblastoma depends on the child’s age, stage of the disease, tumor location, and biological characteristics such as genetic mutations. Patients with neuroblastoma are classified into low-, intermediate-, and high-risk groups, and treatment strategies are adapted accordingly.
Main treatment methods for neuroblastoma in Belarus
- Surgical removal. At early stages, neuroblastoma can be surgically removed. If the tumor is small and well localized, surgery may be the only required treatment. At more advanced stages, when the tumor has spread, surgery is used to remove as much of the tumor as possible, followed by additional therapies.
- Chemotherapy. Chemotherapy is used to reduce tumor size before surgery (neoadjuvant chemotherapy) or to destroy remaining cancer cells after surgery (adjuvant chemotherapy). In children with high-risk neuroblastoma, chemotherapy may include combinations of potent drugs such as cyclophosphamide, doxorubicin, vincristine, etoposide, and carboplatin. Treatment is administered in cycles with recovery intervals.
- Radiation therapy. Radiation therapy is used to eliminate tumor cells that cannot be surgically removed. In children with high-risk neuroblastoma, radiation therapy may be applied after chemotherapy and surgery. In some cases, modern radiation techniques are used to minimize damage to healthy tissues.
- Myeloablative therapy followed by stem cell transplantation. In high-risk neuroblastoma, intensive chemotherapy (myeloablative therapy) is administered to destroy bone marrow cells, including cancer cells. This is followed by stem cell transplantation to restore bone marrow function. Typically, autologous stem cells (collected from the child) are used.
- Immunotherapy. Immunotherapy uses antibodies that help the immune system recognize and attack cancer cells. For example, dinutuximab (an anti-GD2 monoclonal antibody) is used in the treatment of high-risk neuroblastoma. Immunotherapy is often combined with chemotherapy and stem cell transplantation.
- Targeted therapy and innovative approaches. In selected cases, targeted drugs aimed at specific molecular pathways of the tumor may be used. Clinical trials are also exploring new approaches such as CAR T-cell therapy, which uses genetically modified T cells to fight cancer cells.
Long-term follow-up
- Regular medical examinations. Even after successful treatment, children require regular follow-up to monitor for possible relapse and assess overall health.
- Monitoring growth and development. Treatment may affect physical growth and hormonal development, making long-term monitoring essential.
- Prevention and management of long-term complications. Survivors may have an increased risk of cardiovascular disease, organ dysfunction, and secondary malignancies. Regular follow-up allows early detection and management of these complications.
Factors influencing treatment outcomes
- Stage of disease. Prognosis depends on the stage at diagnosis. Early stages (I–II) generally have a favorable outcome, while advanced stages (III–IV) require more aggressive treatment.
- Age of the child. Children younger than 18 months often have a better prognosis, even in cases of metastatic disease.
- Tumor biology. Genetic and molecular characteristics of the tumor play a crucial role in prognosis. Certain genetic alterations are associated with more aggressive disease behavior.
Treatment of neuroblastoma in children is a complex, multi-stage process that requires coordinated work by a multidisciplinary medical team. Early diagnosis and appropriately tailored therapy significantly increase the chances of recovery. Families should be prepared for long-term treatment and rehabilitation, as well as for supporting the child’s physical and emotional recovery.
Q&A
Нет, нейробластома — это заболевание, причины которого часто связаны с генетическими изменениями, которые невозможно предотвратить.
