Showing posts with label neuroblastoma awareness.. Show all posts
Showing posts with label neuroblastoma awareness.. Show all posts
Sunday, July 24, 2011
Wednesday, October 13, 2010
Yesterday
I surpassed my goal of getting 30 visitors to www.neuroblastomaawareness.com and got 8 more then my goal was! Keep it up! My next goal is for 50 a day! Today we've only had 3 but I posted in the post below information about neuroblastoma and pesticides effects. It is a journal article so you may need a membership or I can email you a copy of it.
God bless all those with, fighting or who have lost their battle with neuroblastoma
God bless all those with, fighting or who have lost their battle with neuroblastoma
Monday, October 11, 2010
Stages of Neuroblastoma
After neuroblastoma has been diagnosed, tests are done to find out if cancer has spread from where it started to other parts of the body.
The process used to find out the extent or spread of cancer is called staging. The information gathered from the staging process helps determine the stage of the disease. For neuroblastoma, stage is one of the factors used to plan treatment. The following tests and procedures may be used to determine the stage:
Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
Lymph nodebiopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. One of the following types of biopsies may be done:
Excisional biopsy: The removal of an entire lymph node.
Incisional biopsy: The removal of part of a lymph node.
Core biopsy: The removal of tissue from a lymph node using a wide needle.
Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid from a lymph node using a thin needle.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
X-rays of the chest, bones, and abdomen: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
Radionuclide scan: A procedure to find areas in the body where cells, such as cancer cells, are dividing rapidly. A very small amount of radioactive material is swallowed or injected into a vein and travels through the bloodstream. The radioactive material collects in the bones or other tissues and is detected by a radiation-measuring device.
There are three ways that cancer spreads in the body.
Through tissue. Cancer invades the surrounding normal tissue.
Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for neuroblastoma:
Stage 1
In stage 1, the tumor is in only one area and all of the tumor that can be seen is completely removed during surgery.
Stage 2
Stage 2 is divided into stage 2A and 2B.
Stage 2A: The tumor is in only one area and all of the tumor that can be seen cannot be completely removed during surgery.
Stage 2B: The tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery. Cancercells are found in the lymph nodes near the tumor.
Stage 3
In stage 3, one of the following is true:
the tumor cannot be completely removed during surgery and has spread from one side of the body to the other side and may also have spread to nearby lymph nodes; or
the tumor is in only one area, on one side of the body, but has spread to lymph nodes on the other side of the body; or
the tumor is in the middle of the body and has spread to tissues or lymph nodes on both sides of the body, and the tumor cannot be removed by surgery.
Stage 4
Stage 4 is divided into stage 4 and stage 4S.
In stage 4, the tumor has spread to distant lymph nodes, the skin, or other parts of the body.
In stage 4S, the following are true:
the child is younger than 1 year; and
the cancer has spread to the skin, liver, and/or bone marrow; and
the tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery; and/or
cancer cells may be found in the lymph nodes near the tumor.
Treatment of neuroblastoma is based on risk groups.
For many types of cancer, stages are used to plan treatment. For neuroblastoma, treatment depends on risk groups. The stage of neuroblastoma is one factor used to determine risk group. Other factors are the age of the child, tumor histology, and tumor biology.
There are 3 risk groups: low risk, intermediate risk, and high risk.
Low-risk and intermediate-risk neuroblastoma have a good chance of being cured.
High-risk neuroblastoma may be difficult to cure.
sources:http://www.webmd.com/cancer/tc/neuroblastoma-treatment-patient-information-nci-pdq-stages-of-neuroblastoma
The process used to find out the extent or spread of cancer is called staging. The information gathered from the staging process helps determine the stage of the disease. For neuroblastoma, stage is one of the factors used to plan treatment. The following tests and procedures may be used to determine the stage:
Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
Lymph nodebiopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. One of the following types of biopsies may be done:
Excisional biopsy: The removal of an entire lymph node.
Incisional biopsy: The removal of part of a lymph node.
Core biopsy: The removal of tissue from a lymph node using a wide needle.
Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid from a lymph node using a thin needle.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
X-rays of the chest, bones, and abdomen: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
Radionuclide scan: A procedure to find areas in the body where cells, such as cancer cells, are dividing rapidly. A very small amount of radioactive material is swallowed or injected into a vein and travels through the bloodstream. The radioactive material collects in the bones or other tissues and is detected by a radiation-measuring device.
There are three ways that cancer spreads in the body.
Through tissue. Cancer invades the surrounding normal tissue.
Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for neuroblastoma:
Stage 1
In stage 1, the tumor is in only one area and all of the tumor that can be seen is completely removed during surgery.
Stage 2
Stage 2 is divided into stage 2A and 2B.
Stage 2A: The tumor is in only one area and all of the tumor that can be seen cannot be completely removed during surgery.
Stage 2B: The tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery. Cancercells are found in the lymph nodes near the tumor.
Stage 3
In stage 3, one of the following is true:
the tumor cannot be completely removed during surgery and has spread from one side of the body to the other side and may also have spread to nearby lymph nodes; or
the tumor is in only one area, on one side of the body, but has spread to lymph nodes on the other side of the body; or
the tumor is in the middle of the body and has spread to tissues or lymph nodes on both sides of the body, and the tumor cannot be removed by surgery.
Stage 4
Stage 4 is divided into stage 4 and stage 4S.
In stage 4, the tumor has spread to distant lymph nodes, the skin, or other parts of the body.
In stage 4S, the following are true:
the child is younger than 1 year; and
the cancer has spread to the skin, liver, and/or bone marrow; and
the tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery; and/or
cancer cells may be found in the lymph nodes near the tumor.
Treatment of neuroblastoma is based on risk groups.
For many types of cancer, stages are used to plan treatment. For neuroblastoma, treatment depends on risk groups. The stage of neuroblastoma is one factor used to determine risk group. Other factors are the age of the child, tumor histology, and tumor biology.
There are 3 risk groups: low risk, intermediate risk, and high risk.
Low-risk and intermediate-risk neuroblastoma have a good chance of being cured.
High-risk neuroblastoma may be difficult to cure.
sources:http://www.webmd.com/cancer/tc/neuroblastoma-treatment-patient-information-nci-pdq-stages-of-neuroblastoma
Sunday, October 10, 2010
Less-Intense Chemo Effective in Children with Intermediate-Risk Neuroblastoma
Infants and children with intermediate-risk neuroblastoma who received a less-intensive chemotherapy regimen had three-year overall survival rates as good as those patients in an earlier trial who received treatment that was more intensive and more toxic
Background
Neuroblastoma, the fourth most common solid tumor in children under the age of 16, begins in immature nerve cells, most often in the adrenal gland, neck, chest, or spinal cord. Neuroblastoma is classified as low, intermediate, or high risk of disease recurrence after treatment, based on factors such as the patient’s age, how far the disease has spread (metastasized), and what genetic mutations are found in the tumor.
For neuroblastoma tumors that have already spread within a limited region at the time of diagnosis, doctors can use a combination of surgery and chemotherapy to kill both the original tumor and cancer cells elsewhere. For children with intermediate-risk neuroblastoma, this treatment approach is very effective at preventing the cancer from returning and also increases survival.
However, while effective, this approach requires many months to complete and causes potentially serious side effects, including damage to the kidneys, heart, and hearing as well as a temporary decrease in white blood cells that can expose the patient to dangerous infections.
The clinical trial described below examined whether a shorter, less-intense course of chemotherapy could be as effective in preventing disease recurrence and extending survival as more-intense regimens in children with intermediate-risk neuroblastoma.
The Study
Between March 1997 and May 2005, this single-arm phase III clinical trial (called A3961) enrolled 467 eligible patients with intermediate-risk neuroblastoma from participating hospitals in Australia, New Zealand, and North America. The study used historical patient controls. That is, the investigators compared the results from the A3961 trial to an earlier study (called CCG 3881) performed by the Children’s Cancer Group among a similar population of neuroblastoma patients who had received a more-intense chemotherapy regimen between 1989 and 1996.
All participants in the A3961 trial underwent initial surgery, and were divided into two groups based on the relative likelihood of tumor recurrence—a ‘favorable’ prognosis group and an ‘unfavorable’ prognosis group.
Infants and children in the favorable-prognosis group were scheduled to receive four cycles of chemotherapy, and those in the unfavorable-prognosis group were scheduled to receive eight cycles. If a patient in the favorable-prognosis group did not experience a satisfactory tumor response to the initial treatment, the patient could receive the full eight cycles of chemotherapy. The cycles consisted of different combinations of the drugs carboplatin, etoposide, cyclophosphamide, and doxorubicin.
Based on the results from the earlier CCG-3881 study, investigators determined that the less-intense regimen would be effective if more than 90 percent of A3961 participants were alive after three years of follow up.
The trial was organized by the Children’s Oncology Group. The lead author of the study is David L. Baker, M.B.B.S., director of the pediatric and adolescent hematology-oncology program at Princess Margaret Hospital for Children, Perth, Australia.
Results
Of the 467 eligible patients, 362 were infants (under 1 year of age) and 105 were children. Seventy-one percent (330) of all patients had a favorable prognosis, and 29 percent (137) had an unfavorable prognosis. A total of 192 patients received only four cycles of chemotherapy. The other 275 received eight cycles (including 42 percent of those in the favorable prognosis group).
At three years of follow up, 96 percent of patients remained alive and 88 percent had no progression of their cancer, an outcome indicating that the treatment was indeed effective. What’s more, the patients’ overall length of treatment and the actual number of treatment days were much less compared to the CCG-3881 historical controls.
In the earlier study using a higher-intensity regimen, patients received 71 days of treatment over the course of 268 days. In the A3961 lower-intensity study, patients with an unfavorable prognosis received 18 days of treatment (a 75 percent reduction) over the course of 168 days (a 40 percent reduction). Patients in the favorable group received 10 days of treatment (an 85 percent reduction) over the course of 84 days (a 70 percent reduction).
Damage to the kidneys, heart, and hearing each occurred in less than 2 percent of patients. Almost 70 percent of patients experienced a reduction in their number of white blood cells, but this side effect went away after treatment ended. Four of the 467 patients died from treatment-related infections during the trial. Two patients developed a second cancer - acute myeloid leukemia.
Limitations
While the overall side effects were acceptable after three years of follow up, “the long-term toxicity is unknown,” said pediatric oncologist Andrew Pearson from the Royal Marsden Hospital, Surrey, United Kingdom, in a discussion at the ASCO meeting. Because patients in the unfavorable prognosis group still received a substantial dose of doxorubicin (which can permanently damage the heart), and because several cases of second cancers have already been observed, he explained, “we must aim to reduce therapy even more in this group of patients.”
Comments
Even with further room for improvement in toxicity reduction, “Without question, this is a major success,” said Pearson.
“Their goal was to have an equivalent survival outcome while using much less treatment [compared to the historical control group], and they were able to do that. It’s significant that they were able to get that same outcome with about half the number of cycles of chemotherapy,” agreed Barry Anderson, M.D., Ph.D., of the National Cancer Institute’s Cancer Therapy Evaluation Program.
sources:
Background
Neuroblastoma, the fourth most common solid tumor in children under the age of 16, begins in immature nerve cells, most often in the adrenal gland, neck, chest, or spinal cord. Neuroblastoma is classified as low, intermediate, or high risk of disease recurrence after treatment, based on factors such as the patient’s age, how far the disease has spread (metastasized), and what genetic mutations are found in the tumor.
For neuroblastoma tumors that have already spread within a limited region at the time of diagnosis, doctors can use a combination of surgery and chemotherapy to kill both the original tumor and cancer cells elsewhere. For children with intermediate-risk neuroblastoma, this treatment approach is very effective at preventing the cancer from returning and also increases survival.
However, while effective, this approach requires many months to complete and causes potentially serious side effects, including damage to the kidneys, heart, and hearing as well as a temporary decrease in white blood cells that can expose the patient to dangerous infections.
The clinical trial described below examined whether a shorter, less-intense course of chemotherapy could be as effective in preventing disease recurrence and extending survival as more-intense regimens in children with intermediate-risk neuroblastoma.
The Study
Between March 1997 and May 2005, this single-arm phase III clinical trial (called A3961) enrolled 467 eligible patients with intermediate-risk neuroblastoma from participating hospitals in Australia, New Zealand, and North America. The study used historical patient controls. That is, the investigators compared the results from the A3961 trial to an earlier study (called CCG 3881) performed by the Children’s Cancer Group among a similar population of neuroblastoma patients who had received a more-intense chemotherapy regimen between 1989 and 1996.
All participants in the A3961 trial underwent initial surgery, and were divided into two groups based on the relative likelihood of tumor recurrence—a ‘favorable’ prognosis group and an ‘unfavorable’ prognosis group.
Infants and children in the favorable-prognosis group were scheduled to receive four cycles of chemotherapy, and those in the unfavorable-prognosis group were scheduled to receive eight cycles. If a patient in the favorable-prognosis group did not experience a satisfactory tumor response to the initial treatment, the patient could receive the full eight cycles of chemotherapy. The cycles consisted of different combinations of the drugs carboplatin, etoposide, cyclophosphamide, and doxorubicin.
Based on the results from the earlier CCG-3881 study, investigators determined that the less-intense regimen would be effective if more than 90 percent of A3961 participants were alive after three years of follow up.
The trial was organized by the Children’s Oncology Group. The lead author of the study is David L. Baker, M.B.B.S., director of the pediatric and adolescent hematology-oncology program at Princess Margaret Hospital for Children, Perth, Australia.
Results
Of the 467 eligible patients, 362 were infants (under 1 year of age) and 105 were children. Seventy-one percent (330) of all patients had a favorable prognosis, and 29 percent (137) had an unfavorable prognosis. A total of 192 patients received only four cycles of chemotherapy. The other 275 received eight cycles (including 42 percent of those in the favorable prognosis group).
At three years of follow up, 96 percent of patients remained alive and 88 percent had no progression of their cancer, an outcome indicating that the treatment was indeed effective. What’s more, the patients’ overall length of treatment and the actual number of treatment days were much less compared to the CCG-3881 historical controls.
In the earlier study using a higher-intensity regimen, patients received 71 days of treatment over the course of 268 days. In the A3961 lower-intensity study, patients with an unfavorable prognosis received 18 days of treatment (a 75 percent reduction) over the course of 168 days (a 40 percent reduction). Patients in the favorable group received 10 days of treatment (an 85 percent reduction) over the course of 84 days (a 70 percent reduction).
Damage to the kidneys, heart, and hearing each occurred in less than 2 percent of patients. Almost 70 percent of patients experienced a reduction in their number of white blood cells, but this side effect went away after treatment ended. Four of the 467 patients died from treatment-related infections during the trial. Two patients developed a second cancer - acute myeloid leukemia.
Limitations
While the overall side effects were acceptable after three years of follow up, “the long-term toxicity is unknown,” said pediatric oncologist Andrew Pearson from the Royal Marsden Hospital, Surrey, United Kingdom, in a discussion at the ASCO meeting. Because patients in the unfavorable prognosis group still received a substantial dose of doxorubicin (which can permanently damage the heart), and because several cases of second cancers have already been observed, he explained, “we must aim to reduce therapy even more in this group of patients.”
Comments
Even with further room for improvement in toxicity reduction, “Without question, this is a major success,” said Pearson.
“Their goal was to have an equivalent survival outcome while using much less treatment [compared to the historical control group], and they were able to do that. It’s significant that they were able to get that same outcome with about half the number of cycles of chemotherapy,” agreed Barry Anderson, M.D., Ph.D., of the National Cancer Institute’s Cancer Therapy Evaluation Program.
sources:
Neuroblastoma Treatment..
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Low-Risk Neuroblastoma
Treatment of low-risk neuroblastoma may include the following:
* Watchful waiting alone for certain infants.
* Surgery followed by watchful waiting.
* Surgery followed by combination chemotherapy, when serious health problems occur.
* Radiation therapy to treat tumors that are causing serious health problems and do not respond quickly to chemotherapy.
* A clinical trial of surgery followed by chemotherapy. Radiation therapy is given to treat tumors that are causing serious health problems and do not respond quickly to surgery and chemotherapy.
Intermediate-Risk Neuroblastoma
Treatment of intermediate-risk neuroblastoma may include the following:
* Surgery alone.
* Surgery followed by chemotherapy. Sometimes a second surgery is needed.
* Surgery followed by chemotherapy. Radiation therapy may given to treat tumors that are causing serious health problems and do not respond quickly to surgery and chemotherapy.
* Chemotherapy followed by surgery.
* Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy.
* A clinical trial of lower doses of chemotherapy.
High-Risk Neuroblastoma
Treatment of high-risk neuroblastoma may include the following:
* Combination chemotherapy followed by surgery to remove as much of the tumor as possible, followed by high-dose chemotherapy and stem cell transplant.
* Radiation therapy to the tumor site and, sometimes, if needed, to other parts of the body with cancer.
* 13-cis retinoic acid after recovery from previous treatment.
* A clinical trial of new regimens of chemotherapy and radiation therapy with stem cell transplant.
* A clinical trial of monoclonal antibody therapy, biologic therapy, and 13-cis retinoic acid after chemotherapy.
* A clinical trial of radiation therapy with radioactive iodine and chemotherapy before stem cell transplant.
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.
* High-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.
* A clinical trial of surgery and if needed, chemotherapy and another surgery.
Treatment for recurrent neuroblastoma that has spread to other parts of the body may include the following:
* Watchful waiting.
* Surgery followed by chemotherapy.
* High-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.
* A clinical trial of a new treatment.
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, with or without chemotherapy.
* A clinical trial of surgery and more courses of chemotherapy.
* A clinical trial of a new treatment.
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
There is no standard treatment for recurrent neuroblastoma in patients first treated for high-risk neuroblastoma. Patients may want to consider a clinical trial. For information about clinical trials, please see the NCI Web site.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with neuroblastoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Sources:http://www.cancer.gov/cancertopics/pdq/treatment/neuroblastoma/Patient/page5
Low-Risk Neuroblastoma
Treatment of low-risk neuroblastoma may include the following:
* Watchful waiting alone for certain infants.
* Surgery followed by watchful waiting.
* Surgery followed by combination chemotherapy, when serious health problems occur.
* Radiation therapy to treat tumors that are causing serious health problems and do not respond quickly to chemotherapy.
* A clinical trial of surgery followed by chemotherapy. Radiation therapy is given to treat tumors that are causing serious health problems and do not respond quickly to surgery and chemotherapy.
Intermediate-Risk Neuroblastoma
Treatment of intermediate-risk neuroblastoma may include the following:
* Surgery alone.
* Surgery followed by chemotherapy. Sometimes a second surgery is needed.
* Surgery followed by chemotherapy. Radiation therapy may given to treat tumors that are causing serious health problems and do not respond quickly to surgery and chemotherapy.
* Chemotherapy followed by surgery.
* Radiation therapy to treat tumors that are causing serious problems and do not respond quickly to chemotherapy.
* A clinical trial of lower doses of chemotherapy.
High-Risk Neuroblastoma
Treatment of high-risk neuroblastoma may include the following:
* Combination chemotherapy followed by surgery to remove as much of the tumor as possible, followed by high-dose chemotherapy and stem cell transplant.
* Radiation therapy to the tumor site and, sometimes, if needed, to other parts of the body with cancer.
* 13-cis retinoic acid after recovery from previous treatment.
* A clinical trial of new regimens of chemotherapy and radiation therapy with stem cell transplant.
* A clinical trial of monoclonal antibody therapy, biologic therapy, and 13-cis retinoic acid after chemotherapy.
* A clinical trial of radiation therapy with radioactive iodine and chemotherapy before stem cell transplant.
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.
* High-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.
* A clinical trial of surgery and if needed, chemotherapy and another surgery.
Treatment for recurrent neuroblastoma that has spread to other parts of the body may include the following:
* Watchful waiting.
* Surgery followed by chemotherapy.
* High-dose chemotherapy, stem cell transplant, and 13-cis retinoic acid.
* A clinical trial of a new treatment.
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, with or without chemotherapy.
* A clinical trial of surgery and more courses of chemotherapy.
* A clinical trial of a new treatment.
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
There is no standard treatment for recurrent neuroblastoma in patients first treated for high-risk neuroblastoma. Patients may want to consider a clinical trial. For information about clinical trials, please see the NCI Web site.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with neuroblastoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Sources:http://www.cancer.gov/cancertopics/pdq/treatment/neuroblastoma/Patient/page5
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