Low-Risk Neuroblastoma

Treatment of low-risk neuroblastoma may include the following:

• Surgery followed by watchful waiting.
• Watchful waiting alone for certain infants.
• Surgery followed by chemotherapy, when less than half of the tumor is removed or when serious symptoms cannot be relieved by surgery.
• Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy.
• Low-dose chemotherapy.

Information about ongoing clinical trials is available from the NCI Web site.

Intermediate-Risk Neuroblastoma

Treatment of intermediate-risk neuroblastoma may include the following:

• Chemotherapy.
• Chemotherapy followed by surgery and/or radiation therapy.
• Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy.

High-Risk Neuroblastoma

Treatment of high-risk neuroblastoma may include the following:

• High-dose chemotherapy followed by surgery to remove as much of the tumor as possible.
• Radiation therapy to the tumor site and, if needed, to other parts of the body with cancer.
• Stem cell transplant.
• Chemotherapy followed by 13-cis retinoic acid.
• A clinical trial of monoclonal antibody therapy after chemotherapy.
• A clinical trial of radiation therapy with radioactive iodine before stem cell transplant.
• A clinical trial of stem cell transplant followed by 13-cis retinoic acid.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Progressive/Recurrent Neuroblastoma

PATIENTS FIRST TREATED FOR LOW-RISK NEUROBLASTOMA

Treatment for recurrent neuroblastoma that is found in one place in the body may include the following:

• Surgery followed by watchful waiting or chemotherapy.
• Chemotherapy.
• High-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.

Treatment for recurrent neuroblastoma that has spread to other parts of the body may include the following:

• Watchful waiting.
• Surgery followed by chemotherapy.
• Chemotherapy.
• High-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.
• A clinical trial of a new treatment.

Information about ongoing clinical trials is available from the NCI Web site.

PATIENTS FIRST TREATED FOR INTERMEDIATE-RISK NEUROBLASTOMA

For recurrent neuroblastoma that is found in one place in the body, treatment is usually surgery, with or without chemotherapy.

For recurrent neuroblastoma that has spread to other parts of the body, treatment is usually high-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.

PATIENTS FIRST TREATED FOR HIGH-RISK NEUROBLASTOMA

Treatment of recurrent neuroblastoma in patients first treated for high-risk neuroblastoma may include the following:

• A clinical trial of chemotherapy followed by monoclonal antibody therapy.
• A clinical trial of radiation therapy with radioactive iodine, alone or before stem cell transplant.
• A clinical trial of stem cell transplant.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with neuroblastoma.