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
scan or MRI to determine the size of the tumor.
scans and bone marrow aspiration to rule out metastasis.
of the tumor confirms the diagnosis.
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.
resection of the tumor, Chemotherapy and radiotherapy are used
in different combinations.
localized tumor which is resectable -
either of these three options is used.
remove the cancer
plus radiation therapy.
Unresectable Neuroblastoma -
to remove the cancer followed by Chemotherapy
with or without radiation therapy to reduce the tumor,
followed by surgery
agents- These are
given in cycles and include Cyclophosphamide, Adriamycin,
ifosfamide, cisplatin, carboplatin, vincristine, doxorubicin,
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.