At Memorial Sloan-Kettering's Neuroblastoma Program, we evaluate each patient individually and evaluate treatment options together with the child's family to determine which kind of therapy may be most appropriate.
2. What do we do for patients with Stage 1, Stage 2, or Stage 4S neuroblastoma?
After surgery, the physician generally recommends close follow-up and tries to avoid chemotherapy or radiation therapy. Some babies with Stage 4S tumors have large tumors and even have neuroblastoma in distant lymph nodes and other parts of the body. Even if there is recurrence or progression of neuroblastoma within this stage group, we generally recommend close observation but no chemotherapy and no radiation therapy.
5. What do we do for children newly diagnosed with Stage 4 neuroblastoma at greater than or equal to 18 months of age?
We use only five cycles of chemotherapy (three cycles of cyclophosphamide plus doxorubicin plus vincristine, and two cycles of cisplatin plus etoposide) plus surgery, 3F8 immunotherapy, local radiation therapy, and Accutane. Stem cell transplantation is not included in this treatment program.
6. What do we do for patients with Stage 4 neuroblastoma whose cancer has relapsed or progressed?
We start with chemotherapy or, if possible, surgery to control the growing disease. Depending on how the relapse responds to chemotherapy, treatment options include 3F8 immunotherapy, local radiation therapy, and liquid radiation treatments with 131I-MIBG or 131I-3F8, new agents.