Skip to content
My WebMD Sign In, Sign Up

Brain Cancer Health Center

Font Size

Neuroblastoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information

continued...

Children's Oncology Group Neuroblastoma Risk Grouping

In North America, the COG investigated a risk-based neuroblastoma treatment plan that assigned all patients to a low-, intermediate-, or high-risk group based on age, INSS stage, and tumor biology. The relevant biological attributes of the tumor included MYCN status, International Neuroblastoma Pathologic Classification (INPC) histopathology classification, and tumor DNA index. The low-risk group was observed without further treatment unless the patient had life- or organ-threatening tumors. The intermediate-risk group received limited chemotherapy, additional surgery in some instances, and avoided radiation therapy. This study involved an overall reduction in treatment compared to prior treatment plans.[11] The high-risk group was treated with aggressive chemotherapy, second-look surgery, high-dose chemotherapy with stem cell rescue, radiation therapy, and cis -retinoic acid. The outcome for the low- and intermediate-risk groups combined was an event-free survival and overall 3-year survival of 88% and 96%, respectively. There was no unexpected toxicity.[11] These studies (COG-P9641 and COG-A3961) have established a new standard of care for children in North America with neuroblastoma.

Some controversies exist regarding the treatment of several small subsets of patients and the INSS staging system;[12,13,14] risk group assignment and recommended treatment are expected to mature as additional outcome data are analyzed. For example, the risk group for INSS stage 4, including patients aged 12 to 18 months was changed for patients with MYCN-nonamplified status in 2005.[15,16,17] Table 1 describes the risk group assignment criteria used to assign treatment in these studies.

1|2|3

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

human brain xray
Article
Computed Tomography CT Scan Of The Head
Article
 
Integrative Medicine Cancer Quiz
Article
what is your cancer risk
Health Check
 

Malignant Gliomas
Article
Pets Improve Your Health
SLIDESHOW
 
Headache Emergencies
Video
life after a brain tumor
VIDEO
 

Would you consider trying alternative or complementary therapies?


WebMD Special Sections