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==Overview== | |||
Children oncology group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients. Low risk neuroblastoma patients are usually managed with either observation or surgical resection of the tumor. Intermidiate risk neuroblastoma patients are usually managed with neoadjuvant chemotherapy in advance of a definitive surgical resection. Whereas high risk neuroblastoma patients are usually managed with a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy. | Children oncology group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients. Low risk neuroblastoma patients are usually managed with either observation or surgical resection of the tumor. Intermidiate risk neuroblastoma patients are usually managed with neoadjuvant chemotherapy in advance of a definitive surgical resection. Whereas high risk neuroblastoma patients are usually managed with a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy. | ||
==Medical Therapy== | |||
Low risk neuroblastoma patients are managed | ===Risk Stratification=== | ||
Intermediate risk neuroblastoma patients are managed | * Children oncology group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients. | ||
High risk neuroblastoma patients are managed | * Low risk neuroblastoma patients are usually managed by either observation or surgical resection of the tumor. | ||
* Intermediate risk neuroblastoma patients are usually managed by neoadjuvant chemotherapy in advance of a definitive surgical resection. | |||
* High risk neuroblastoma patients are usually managed by a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy. | |||
* The algorithm below summarizes the management approach for neuroblastoma patients: | |||
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===Management of Low Risk Neuroblastoma Patients=== | |||
* Surgical intervention alone may be curative as a single therapeutic modality for the management of low risk neuroblastoma patients. | |||
* Indications for chemotherapy among low risk neuroblastoma patients include: | |||
:* Stage 1 or stage 2 tumors associated with MYCN amplification | |||
:* Age older than 18 months presenting with a stage 2B tumor and an unfavorable histology | |||
:* Symptomatic patients due to spinal cord compression, respiratory compromise, and hepatic infiltration | |||
* The majority of low risk neuroblastoma cases among infants younger than 6 months of age may spontaneously regress. Such patients may safely be observed without obtaining a definitive histologic diagnosis or performing any surgical intervention. | |||
Revision as of 20:38, 9 October 2015
Overview
Children oncology group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients. Low risk neuroblastoma patients are usually managed with either observation or surgical resection of the tumor. Intermidiate risk neuroblastoma patients are usually managed with neoadjuvant chemotherapy in advance of a definitive surgical resection. Whereas high risk neuroblastoma patients are usually managed with a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy.
Medical Therapy
Risk Stratification
- Children oncology group (COG) risk stratification system determines the protocol of management used for neuroblastoma patients.
- Low risk neuroblastoma patients are usually managed by either observation or surgical resection of the tumor.
- Intermediate risk neuroblastoma patients are usually managed by neoadjuvant chemotherapy in advance of a definitive surgical resection.
- High risk neuroblastoma patients are usually managed by a combination of surgery, chemotherapy, radiation therapy, hematopoietic stem cell transplantation, and immunotherapy.
- The algorithm below summarizes the management approach for neuroblastoma patients:
Children's oncology group risk stratification | |||||||||||||||||||||||||||||
Low risk patients | Intermediate risk patients | High risk patients | |||||||||||||||||||||||||||
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Management of Low Risk Neuroblastoma Patients
- Surgical intervention alone may be curative as a single therapeutic modality for the management of low risk neuroblastoma patients.
- Indications for chemotherapy among low risk neuroblastoma patients include:
- Stage 1 or stage 2 tumors associated with MYCN amplification
- Age older than 18 months presenting with a stage 2B tumor and an unfavorable histology
- Symptomatic patients due to spinal cord compression, respiratory compromise, and hepatic infiltration
- The majority of low risk neuroblastoma cases among infants younger than 6 months of age may spontaneously regress. Such patients may safely be observed without obtaining a definitive histologic diagnosis or performing any surgical intervention.