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Neuroblastoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Options for Neuroblastoma

Low-Risk Neuroblastoma

Treatment of low-risk neuroblastoma may include the following:

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  • Surgery followed by observation.
  • Chemotherapy with or without surgery, for some patients.
  • Observation alone for infants who do not have signs or symptoms of neuroblastoma. More studies are needed before this is considered a standard treatment.

Intermediate-Risk Neuroblastoma

Treatment of intermediate-risk neuroblastoma may include the following:

  • Chemotherapy with or without surgery.
  • Surgery alone for infants.
  • Observation alone for certain infants.
  • Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy or surgery.
  • Radiation therapy for tumors that do not respond to other treatment.

High-Risk Neuroblastoma

Treatment of high-risk neuroblastoma may include the following:

  • A regimen of combination chemotherapy, surgery, stem cell rescue, radiation therapy, and anti-GD2 ch14.18 with interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), and isotretinoin.
  • A clinical trial of combination chemotherapy and stem cell rescue following chemotherapy.
  • A clinical trial of chemotherapy combined with mIBG, followed by surgery, more chemotherapy, stem cell rescues, radiation therapy, and isotretinoin.
  • A clinical trial of chemotherapy and stem cell rescue followed by isotretinoin with or without monoclonal antibody therapy and biologic therapy.

Stage 4S Neuroblastoma

There is no standard treatment for stage 4S neuroblastoma but treatment options include the following:

  • Observation with supportive care for certain patients who have favorable tumor biology and do not have signs or symptoms.
  • Chemotherapy, for children who have signs or symptoms of neuroblastoma or unfavorable tumor biology, or for very young infants.

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 observation or chemotherapy.
  • Chemotherapy that may be followed by surgery.

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

  • Observation for certain infants.
  • Chemotherapy.
  • Surgery followed by chemotherapy.
  • Combination chemotherapy.

Patients First Treated for Intermediate-Risk Neuroblastoma

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

  • Surgery that may be followed by chemotherapy.

Recurrent neuroblastoma that has spread to other parts of the body is treated the same way as newly diagnosed high-risk neuroblastoma.

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