Neuroblastoma is a cancer originating from immature nerve cells typically found in an embryo or fetus, according to the American Cancer Society. It is usually diagnosed in children, and it usually starts in nerve tissue in the adrenal gland, neck, chest or spinal cord, states the National Cancer Institute. When a recurrence of neuroblastoma occurs, treatment options are based on whether the recurrence is in one or multiple areas, and the risk grouping of the original neuroblastoma diagnosis.
Risk Grouping
When neuroblastoma is originally diagnosed, along with staging, which is categorizing the cancer based on its spread and extent, risk grouping is performed. The risk groups include low, intermediate and high-risk, and these help determine prognosis, according to the American Cancer Society. To determine an individual's risk group, the stage of the neuroblastoma, the age of the patient, and genetic factors are all taken into consideration.
Patients Originally Diagnosed with Low-Risk Neuroblastoma
In patients who originally had low-risk neuroblastoma and the recurrence is only in one area, the National Cancer Institute lists possible treatments as including surgery and either watchful waiting or chemotherapy, high-dose chemotherapy along with a stem-cell transplant and 13-cis retinoic acid, or a clinical trial. The most common chemotherapy combination used to treat neuroblastoma, according to the American Cancer Society, is carboplatin or cisplatin, cyclophosphamide, doxorubicin and etoposide. In the chemotherapy and stem-cell transplant combination, stem cells are harvested from the individual, high doses of chemotherapy are given to kill all the cancer cells, and then the stem cells are reinfused into the patient, making new bone marrow. 13-cis retinoic acid is a chemical that is related to Vitamin A and is hypothesized to help change cancer cells into normal healthy cells, notes the American Cancer Society. If the recurrence involves neuroblastoma that has spread to various parts of the body, these treatments are also an option.
Patients Originally Diagnosed with Intermediate-Risk Neuroblastoma
If the neuroblastoma recurrence is only in one area, patients whose original diagnosis was intermediate-risk neuroblastoma can be treated with surgery, with or without chemotherapy; a clinical trial of surgery and different courses of chemotherapy; or a clinical trial of new treatments, according to the National Cancer Institute. If the neuroblastoma has spread to multiple parts of the body, treatment typically consists of high-dose chemotherapy with a stem-cell transplant and 13-cis retinoic acid.
Patients Originally Diagnosed with High-Risk Neuroblastoma
The National Cancer Institute states that for patients whose neuroblastoma was originally high-risk who have a recurrence, there is no standard treatment for the recurrence. A clinical trial might be appropriate for these patients.
References
- National Cancer Institute: Neuroblastoma Treatment
- American Cancer Society: Neuroblastoma: Retinoid Therapy
- American Cancer Society: Neuroblastoma: high-dose chemotherapy and stem cell transplant
- American Cancer Society: Neuroblastoma: Chemotherapy
- American Cancer Society: how is neuroblastoma staged?
