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Neuroblastoma Treatment (PDQ®)

  • Updated: 01/14/2014

Table 5. Treatment Options for Neuroblastoma

Stage (COG Risk-Group Assignment)  Treatment Options 
COG = Children's Oncology Group; GM-CSF = granulocyte-macrophage colony-stimulating factor; 131I-mIBG = iodine 131-metaiodobenzylguanidine; SCT = stem cell transplant.
Low-Risk Neuroblastoma Surgery.
Observation without biopsy.
Chemotherapy.
Intermediate-Risk Neuroblastoma Surgery and chemotherapy.
Surgery and observation (for infants).
Radiation therapy.
High-Risk Neuroblastoma A regimen of chemotherapy, surgery, SCT, and radiation therapy, isotretinoin (cis-retinoic acid), anti-GD2 antibody ch14.18, and interleukin-2/GM-CSF.
Stage 4S Neuroblastoma Observation with supportive care (for asymptomatic patients).
Chemotherapy (for symptomatic patients).
Recurrent NeuroblastomaLocoregional recurrence in patients initially classified as low riskSurgery followed by observation or chemotherapy.
Metastatic recurrence in patients initially classified as low riskObservation.
Surgery followed by chemotherapy.
Locoregional recurrence in patients initially classified as intermediate riskSurgery (complete resection).
Surgery (incomplete resection) followed by chemotherapy.
Metastatic recurrence in patients initially classified as intermediate riskHigh-dose chemotherapy.
Recurrence in patients initially classified as high riskSecond autologous SCT after retrieval chemotherapy.
Chemotherapy.
131 I-mIBG alone, in combination with other therapy, or followed by stem cell rescue.
Recurrence in the central nervous systemSurgery and radiation therapy.
Novel therapeutic approaches.