How do you treat a Neuroblastoma?

The treatment depends on the stage of the disease.

INNS stages 1 and 2 - Localised operable disease, 20% cases

Following tumour resection, the 5-year survival rate is above 80%, and requires little or no post-operative chemotherapy. The relapse rate is 15 to 20%, and requires aggressive therapy.

INNS stage 3 - Localised inoperable disease, 20-25% of cases

When the tumour invades across the midline it becomes inoperable, and chemotherapy is indicated

INNS stage 4 - Disseminated disease, >50% of cases

This represents half of all cases. For those under 12 months the prognosis is generally good, however others have a 5-year survival rate of 20%. Aggressive chemotherapy is indicated, followed by removal of the primary tumour. This is followed by further chemotherapy which is then followed by one or two cycles of high dose chemotherapy. This may or may not be accompanied by radiotherapy.

INNS stage 4s - Multifocal disease, 5-10% of cases

This affects mainly children under 12 months, and affects the liver, skin, bone marrow and the adrenal glands. This tends to regress spontaneously. Diagnosis before 2 months and infiltration of the liver give a poor prognosis.