Chemotherapy for Neuroblastoma

Chemotherapy is treatment intended to kill cancer cells with anticancer drugs. Anticancer drugs are administered orally or by intravenous injection, and the drug is delivered to the cancer cells throughout the body by the bloodstream. The drug is taken up by the cancer cells and exerts therapeutic effects by inhibiting the growth of cancer cells or killing them. An anticancer drug is sometimes used alone and sometimes as combinations of two or more drugs. Combination of two or more drugs is common for childhood cancers.

The type of anticancer drug varies according to the type of cancer and the risk group (stage of progression and degree of malignancy). Anticancer drugs used for neuroblastoma include vincristine, cyclophosphamide, ifosfamide, doxorubicin, pirarubicin, cisplatin, carboplatin, and etoposide, and these are used in multiple drug regimens. They are considered to be the most effective for neuroblastoma based on many years's experience.

The combination of anticancer drugs is determined according to the risk group (low risk, intermediate risk, or high risk) and the drugs are used together with surgery or radiation therapy. The regimens are planned to ensure that burden on the patients is not too heavy and a better outcome is achieved.

In approximately 90% of patients in the low risk group, the tumor is only treated with surgery. If a patient has a residual part of the tumor after surgery, or only undergoes biopsy, the mildest kind of chemotherapy is administered for 2 to 3 months.

In patients in the intermediate risk group, both chemotherapy and surgery are used. Chemotherapy is more intensive than that used for patients in the low risk group, and is administered for a longer period, between 4 and 7 months. If a patient has metastatic lesions, the metastatic sites are radiated.

In patients in the high risk group, the most intensive chemotherapy is generally administered in combination with radiation therapy and hematopoietic stem cell transplantation. The duration of the treatment is 8 to 10 months, which is further longer than that for the above-mentioned patients. Surgery is considered a supplementary treatment.

Anticancer drugs have common adverse reactions and ones that are unique to each drug. The adverse reactions may vary according to the dose, mode of administration, frequency of administration, and combination of drugs. If your child has to receive chemotherapy, you need to receive a full explanation. We recommend that chemotherapy is performed at a medical institution with experienced specialists.

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