Treatments for low-risk neuroblastoma

Last medical review:

The following are treatment options for low-risk neuroblastoma. The healthcare team will suggest treatments based on your child's needs and work with you to develop a treatment plan.

Treatments for low-risk neuroblastoma may include:

  • surgery alone
  • chemotherapy with or without surgery
  • radiation therapy (to relieve serious symptoms, if other treatments don't work)
  • watchful waiting (in some cases)

Surgery

Surgery is the main treatment for low-risk neuroblastoma. The type of surgery done will depend on where the tumour started, its size, how close it is to vital organs, major blood vessels and nerves and if it can be removed with surgery (if it is resectable).

If the surgeon can't remove all of the tumour, the tumour gets bigger after surgery or a tumour is causing symptoms, chemotherapy may be given.

Find out more about surgery for neuroblastoma.

Chemotherapy

Chemotherapy is sometimes used to treat low-risk neuroblastoma. Chemotherapy uses anticancer drugs to destroy cancer cells.

Chemotherapy may be given before surgery. It is used to shrink the tumour to control serious symptoms such as spinal cord compression (if the tumour is pressing on the spine) or difficulty breathing (if the liver is enlarged and crowding the lungs). This is done when the tumour can't be safely removed with surgery right away.

Chemotherapy may be given after surgery if the surgeon couldn't remove all of the tumour or if the child has serious symptoms that are not relieved with surgery.

Combination chemotherapy is often given for 2 to 4 cycles. The most common drugs used are:

  • carboplatin or cisplatin
  • cyclophosphamide
  • doxorubicin
  • etoposide
Find out more about chemotherapy for neuroblastoma.

Radiation therapy

Radiation therapy is rarely used to treat low-risk neuroblastoma. Radiation therapy uses high-energy rays or particles to destroy cancer cells. It may be used to treat a tumour that is causing serious symptoms if they are not relieved with other therapies. These symptoms include spinal cord compression (if the tumour is pressing on the spine) or difficulty breathing (if the liver is enlarged and crowding the lungs).

Find out more about radiation therapy for neuroblastoma.

Watchful waiting

Watchful waiting may be a treatment option for some neuroblastomas that don't need to be treated right away. It is sometimes used for babies younger than 6 months who have small tumours or babies with stage MS (4S) disease who have no symptoms.

Find out more about watchful waiting for neuroblastoma.

Clinical trials

Children with cancer may be treated in a clinical trial. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • Meredith Irwin, MD
  • Daniel Morgenstern, MD
  • American Society of Clinical Oncology . Neuroblastoma . 2018 .
  • Lacayo NJ. Pediatric Neuroblastoma. eMedicine/Medscape; 2017: https://emedicine.medscape.com/.
  • Cancer Research UK. Neuroblastoma. Cancer Research UK; 2014.
  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Health ProfessionalVersion. Bethesda, MD: National Cancer Institute ; 2020: https://www.cancer.gov/.
  • Brodeur GM, Hogarty MD, Bagatell R, Mosse YP, Maris JM. Neuroblastoma. Pizzo PA, Poplack DG, eds.. Principles and Practice of Pediatric Oncology . 7th ed. Philadelphia, PA: Wolters Kluwer; 2016: 30:772–797.
  • PDQ® Pediatric Treatment Editorial Board. Neuroblastoma Treatment (PDQ®)–Patient Version. Bethesda, MD: National Cancer Institute; 2021: https://www.cancer.gov/types/neuroblastoma/patient/neuroblastoma-treatment-pdq.
  • American Cancer Society. Treating Neuroblastoma. 2020: https://www.cancer.org/.
  • Bartholomew, J . Neuroblastoma. Baggott C, Fochtman D, Foley GV & Patterson Kelly, K (eds.). Nursing Care of Children and Adolescents with Cancer and Blood Disorders. 4th ed. APHON; 2011: 30: pp. 1038-1053.
  • Lacayo NJ. Medscape: Pediatric Neuroblastoma Treatment and Management. WebMD LLC; 2012.

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