Surgery: Neuroblastoma (Ganglioneuroblastoma)
Neuroblastoma is a malignant tumor growing from cells of the sympathetic nervous system. This abnormality is usually detected in children 1 to 5 years old. After that threshold, the incidence rate is reduced significantly. Theoretically, neuroblastoma may develop in any part of the body, but it is commonly located in the abdomen, chest and neck. When choosing a treatment method, the physician takes into account not only the tumor parameters, but also the patient's risk group.
Low-risk patients usually undergo surgical removal of the tumor only. Thereafter, the child is followed up by the oncologist. In rare cases, surgery is replaced by chemotherapy.
In infants, the spontaneous cure is possible, so they are sometimes subjected to simple observation. If the tumor begins to progress, the need for surgery is considered.
Medium (Intermediate) Risk Group
Such patients are treated comprehensively. In addition to surgical techniques, the chemotherapy and/or radiation therapy is used.
For an inoperable tumor, the chemotherapy is a primary recommendation. Administration of cytotoxic drugs reduces neuroblastoma size, allowing for its partial or complete removal. The modern treatment protocols include platinum drugs, vinca alkaloids, epipodophylotoxins, topoisomerase inhibitors, etc. Antibiotics are selected for prevention of infectious complications.
After tumor removal, radiotherapy or repeated chemotherapy is prescribed. This approach allows destroying the remnants of the cancer cells in the body and prevent the relapse.
Children at high risk are prescribed radical surgery, followed by the high-dose chemotherapy. As the intense effect of cytotoxic drugs leads to suppression of the stem cells functions, the autologous bone marrow transplantation must be conducted.
Biotherapy is often used to prevent the relapses. The patients are usually prescribed 13-cis-retinoic acid, stimulating the normal maturation of nerve cells. Drug treatment takes several months.
Subject to a proper treatment selection, the likelihood of overcoming the neuroblastomas is generally high. The best prognosis is seen in children from the medium and intermediate risk groups, where the number of cured patients reaches 70 to 90%.
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