Radiation therapy for neuroblastoma
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat neuroblastoma. Your child’s healthcare team will consider your child’s personal needs to plan the type and amount of radiation, and when and how it is given. Your child may also receive other treatments.
Radiation therapy is given for different reasons. Your child may have radiation therapy to:
- treat high-risk or recurrent neuroblastoma
- shrink a tumour before other treatments such as surgery or chemotherapy (called neoadjuvant therapy)
- destroy cancer cells left behind after surgery or chemotherapy and lower the risk that the cancer will recur (called adjuvant therapy)
- treat larger tumours that cause serious problems, such as trouble breathing or spinal cord compression, and that do not respond quickly to chemotherapy
- try to reverse vision loss if a tumour in the eye socket causes partial or complete blindness
- prepare for stem cell transplant
- relieve pain or control the symptoms of advanced neuroblastoma (called palliative therapy)
Types of radiation therapy
The following types of radiation therapy are most commonly used to treat neuroblastoma.
External beam radiation therapy
Neuroblastoma is usually treated with external beam radiation therapy. During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.
Targeted radiation therapy
Targeted radiation therapy may be used in a clinical trial to treat high-risk neuroblastoma or recurrent high-risk neuroblastoma.
The targeted radiation therapy used is radioactive metaiodobenzylguanidine (MIBG). MIBG binds to receptors on the neuroblastoma cells. This allows the radiation to be delivered directly to the cancer cells and limits its effects on normal cells. MIBG may be used along with high-dose chemotherapy and stem cell transplant. This treatment is only available in a few Canadian centers and is often only given within a clinical trial.
Side effects can happen with any type of treatment for neuroblastoma, but every child’s experience is different. Some children have many side effects. Others have few or none at all.
During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. Damage to these healthy cells may cause side effects. Side effects can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of external beam radiation therapy will depend mainly on the area treated, total dose and child’s age. Some common side effects of external beam radiation therapy for neuroblastoma include:
- bone marrow suppression
- skin problems
- nausea and vomiting
- sore mouth and throat
- difficulty swallowing
- radiation enteritis
Most children do not have serious side effects from targeted radiation therapy. It can sometimes cause mild nausea and vomiting and fatigue.
Other side effects can develop months or years after treatment for neuroblastoma. Find out more about late effects for neuroblastoma.
Tell the healthcare team if your child has these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help your child deal with them.
Questions to ask about radiation therapy
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.