Because neuroblastoma is rarely seen in adults, it is important that your child receives care from an experienced team of pediatric specialists who focus exclusively on treating childhood cancers. The Neuroblastoma Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center in Boston, MA, treats newly diagnosed and relapsed patients and provides innovative therapies for children with relapsed or hard-to-treat neuroblastomas.
Our neuroblastoma specialists and surgeons are known for treating children with the most complex cases, as well as for their expertise in delivering specialized treatments, including stem cell transplantation. Continue reading to learn about our approach to treating neuroblastoma, or visit our health library to learn about neuroblastoma symptoms, diagnosis and prognosis.
Our doctors perform a variety to tests to diagnose neuroblastomas. Tests may include a 24-hour urine test to measure the amount of certain chemical products made by the tumor, cytogenetic analysis to check for certain changes in chromosomes, and bone marrow aspiration and biopsy to look for signs of cancer. We also use imaging studies—X-rays, CT and MRI scans, and ultrasound—to evaluate the primary tumor and determine if it has spread. A procedure called an MIBG scan uses a radioactive molecule to help our doctors detect neuroblastomas. Many of these tests can also be used to stage the disease.
Treatment of neuroblastomas depends on the patient’s age at diagnosis, stage of the disease, location of the tumor, shape and structure of the tumor, and if it has spread elsewhere in the body. Standard treatments include surgery to remove the tumor, followed by local radiation therapy and high-dose chemotherapy to kill any remaining cancer
cells. Biologic therapies may be used to boost or restore the body’s natural defense against cancer cells. Newer treatments include targeted therapies that attack specific cancer cells without harming nearby healthy cells and high-dose chemotherapy with stem cell transplant to replace blood-forming cells destroyed by cancer treatment. We also use a vitamin-like drug, called 13-cis retinoic acid, to slow the cancer’s ability to make more cells.
We were the first hospital in New England to offer MIBG therapy to treat neuroblastoma, and is currently one of only a handful of hospitals in the country to provide this therapy. Metaiodobenzylguanidine (MIBG) is a compound that can be combined with radioactive iodine (131I) to deliver targeted radiation therapy. 131I-MIBG can be used to treat high-risk neuroblastoma, a cancerous tumor that begins in nerve tissue of infants and very young children.
The I-131 MIBG room is a 256-square-foot hospital room designed specifically for this treatment at Boston Children’s Hospital. The room has added protective features to help manage the therapy safely for the benefit of both patients and staff, and has an anteroom where parents can stay to help with the care of their child and be in close proximity throughout the therapy. During the day, parents can spend time with their child following specific safety procedures to protect them, as well as hospital staff.
Dana-Farber/Boston Children’s patients have access to the broadest set of pediatric and oncologic expertise available. The breadth of our expertise allows us to assemble a team of specialists to meet the specific needs of each patient.
At the core of the treatment team is a pediatric oncologist who specializes in treating children with neuroblastomas. Many of our physicians are also active researchers, so our patients have access to the very best and up-to-date treatments available.
From there, we build a team that is best suited to carry out the patient’s treatment plan, including pediatric surgeons, hematology nurses, pediatric oncology nurse practitioners, imaging specialists, and pathologists. When necessary, our specialists work directly with our pediatric stem cell transplantation team.
We round out the team with experts who help the child prepare for life during and after treatment, including psychiatrists and psychologists, child life specialists, social workers, nutritionists, and school specialists.
Research is a top priority at Dana-Farber/Boston Children’s, and our physicians work continuously to translate laboratory findings into clinical therapies. We sponsor clinical trials for newly diagnosed neuroblastoma patients through the Children’s Oncology Group (COG) and, through COG and the New Approaches to Neuroblastoma Therapy Consortium, Dana-Farber/Boston Children’s offers the most Phase I clinical studies in New England for children whose disease has recurred.
Suzanne Shusterman MD describes MIBG therapy, a treatment available at Dana-Farber/Boston Children's and only a few other centers in the nation.