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Neuroblastoma

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Treatments for recurrent neuroblastoma

The following are treatment options for recurrent neuroblastoma. Your healthcare team will suggest treatments based on your child’s needs and work with you to develop a treatment plan.

High-risk neuroblastoma has a greater chance of recurring than low- or intermediate-risk neuroblastoma. In general, when the disease comes back in only one area, the prognosis is better than when it recurs in many locations, such as bone and bone marrow.

Treatments for recurrent neuroblastoma are given based on the risk group given to the cancer when it was first diagnosed. The treatments offered also depend on the:

  • stage of the cancer at diagnosis
  • certain characteristics of the recurrent tumour, such as chromosome changes
  • where the cancer recurs
  • treatments the child has already received
  • child’s overall health

Treatments for low-risk neuroblastoma that recurs

Children first treated for low-risk neuroblastoma who have a recurrence that is found in one place may be treated with surgery, chemotherapy or both.

If the recurrent neuroblastoma has spread to other parts of the body, it is often treated with chemotherapy. Surgery may be done to remove as much of the recurrent tumour as possible.

Treatments for intermediate-risk neuroblastoma that recurs

Children first treated for intermediate-risk neuroblastoma who have a recurrence that is found in one place may be treated with surgery. Chemotherapy may also be given.

If the recurrent neuroblastoma has spread to other parts of the body, treatment is often aggressive. A combination of therapies are used, including chemotherapy, surgery, radiation therapy, stem cell transplant, retinoids and immunotherapy.

Treatments for high-risk neuroblastoma that recurs

Children first treated for high-risk neuroblastoma who have a recurrence that is found in one place may be treated with chemotherapy, radiation therapy or both. Stem cell transplant (may be called stem cell rescue) may also be used.

Sometimes targeted radioactive metaiodobenzylguanidine (MIBG) therapy may be used to treat high-risk neuroblastoma that recurs. It 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 given within a clinical trial.

Neuroblastoma that recurs in the central nervous system (CNS)

Children who have neuroblastoma that recurs in the CNS (the brain and spinal cord) may have surgery to remove the tumour. Radiation therapy is usually given after surgery.

Clinical trials

Many children with recurrent neuroblastoma are treated in a clinical trial. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.

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