Treatment of neuroblastoma in Germany
Neuroblastoma is a malignant tumor which grows from the embryonic neuroblasts of the sympathetic nervous system. In 99% of cases it affects children under the age of 15. The average age of the patients is 2 years. 90% of patients are children under the age of 5. Neuroblastoma is the most common oncological illness in children under the age of 1 year.
Neuroblastoma – Diagnostics
It is quite difficult to perform an early diagnostics, because the symptoms do not appear at the very beginning of the disease. The age of a patient often does not allow him to express the complaints and even more, to specify them. Two-thirds of the patients have already had metastases in the lymph nodes at the time of visiting a doctor.
The following methods are used for the neuroblastoma diagnostics:
Laboratory methods. 85% of patients have the increased levels of catecholamines in the blood (dopamine is the main one among them). Diagnostics is carried out by determining the daily excretion of urine hormones and their metabolites.
There are also other biochemical markers of neuroblastoma, such as:
- Neuron-specific enolase
Imaging methods. Ultrasound examination, computed tomography, magnetic resonance imaging, and X-rays are used for the neuroblastoma diagnostics. These methods of diagnostics allow to identify the neuroblastoma and its metastasis.
Biopsy is carried out at the final stage of neuroblastoma diagnostics. With the help of a needle, doctor takes a sample of the tumor mass for cytological and immunohistochemical examinations.
Bone marrow puncture is carried out to assess the dissemination of the tumor process. Usually, it is carried out simultaneously with neuroblastoma biopsy while a child is under the general anesthesia.
Scintigraphy. Radioactive isotopes are injected into the body. The MIBG is used if neuroblastoma is suspected. This substance resembles the catecholamines according to the chemical structure. It accumulates in the tumor cells regardless of their location. In a few days or hours child’s body is scanned and neuroblastoma location is identified with all its metastases.
Best clinics for the neuroblastoma diagnostics in German
Rambam Health Care Campus Haifa
Pediatric Diagnostic Hospital M1 Munich
University Hospital Duesseldorf
Neuroblastoma – Treatment
Neuroblastoma treatment includes the following aspects:
- Surgery (tumor resection)
- Radiation therapy
Besides the remote irradiation, MIBG therapy is used as an radiation therapy option. It implies the intravenous injection of the meta-iodobenzyl guanidine. This radioactive substance accumulates in the tumor cells, regardless of their location, and destroys them.
The procedure is performed in the special shielded room. Patient remains completely isolated, as he is radioactive and dangerous during the treatment period. Isolation lasts for a few days.
Patients with the advanced neuroblastoma forms can be treated with the help of highly intensive chemotherapy that presupposes usage of the high doses of the medications. At the same time, it is possible to achieve good results of treatment, taking into consideration stage of the disease.
The relapse-free period is:
- 40% of children – 2 years
- 25% of children – 5 years
- 13% of children – 7 years
A four-year relapse-free period is observed in 30% of patients after the intensive chemotherapy and the stem cells transplantation (bone marrow transplantation).
Neuroblastoma – Innovative treatment
New methods of neuroblastoma treatment are constantly being developed. The medical achievements of the last years are:
- Retinoids. The usage of retinoids (isotretinoin) can significantly reduce the risk of tumor recurrence.
- Targeted therapy is based on the implementation of medications (crizotinib) that influence only the cells with the changed ALK gene. As a result, the tumor shrinks. ALK gene changes are characteristic for the 15% of neuroblastomas.
- Immunotherapy. Monoclonal antibodies (Dinutuximab) are used for the neuroblastoma treatment. They stimulate the immune system activity against the tumor cells. Trials have shown that monoclonal antibodies are effective in some children, who were resistant to chemotherapy.
Best clinics for the neuroblastoma treatment in Germany:
Medicana International Istanbul Hospital
Gamma Knife and Radiotherapy Center Krefeld
University Hospital Duesseldorf
Author: Dr. Nadezhda Ivanisova
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc