Neuroblastoma
Diagnosis
-
Screening
is performed through urine test for vanillylmandelic acid (VMA)
and homovanillic acid (HVA). Seventy-five percent to 90% of
cases of neuroblastoma excrete these substances into the
urine. VMA levels above 25μg/mg creatinine and an HVA
levels greater than 32μg/mg creatinine are considered
abnormal.
-
CT
scan or MRI to determine the size of the tumor.
-
Bone
scans and bone marrow aspiration to rule out metastasis.
-
Biopsy
of the tumor confirms the diagnosis.
Treatment
Treatment
of neuroblastoma depends on the stage of the The risk of
progression of the tumor causing morbidity and mortality is
gauged based on the stage of the tumor, the age of the child at
diagnosis, and tumor biology. The biological features
considered are the Shimada histology, amplification of the N-MYC
gene, and the number of chromosomes in tumor cells.
Surgical
resection of the tumor, Chemotherapy and radiotherapy are used
in different combinations.
1.For
localized tumor which is resectable -
either of these three options is used.
-
Surgery to
remove the cancer
-
Surgery plus
adjuvant chemotherapy
-
Surgery
plus radiation therapy.
2.Localized
Unresectable Neuroblastoma -
3.Regional
Neuroblastoma
-
Surgery
to remove the cancer followed by Chemotherapy
-
Chemotherapy
with or without radiation therapy to reduce the tumor,
followed by surgery
4.Disseminated
Neuroblastoma
-
Chemotherapy
agents- These are
given in cycles and include Cyclophosphamide, Adriamycin,
ifosfamide, cisplatin, carboplatin, vincristine, doxorubicin,
and etoposide.
Radiation
Therapy- Usually used for decreasing the size of a tumor or
after surgery. Also used for treatment of bone metastasis. In
some cases where tumor is causing Chord compression, urgent
radiotherapy may be helpful in rapidly decreasing the size of
the tumor and alleviate the compression. Prognosis for
neuroblastoma is usually good for stage 1 and stage 2 diseases.
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