title: Ten challenges in the management of neuroblastoma.
abstract: Neuroblastoma is a complex disease with many contradictions and challenges. It is, by and large, a cancer of babies and preschool children, but it does occur, albeit increasingly rarely, in older children, adolescents and young adults. The prognosis is very variable, with outcome related to age, stage and molecular pathology. Neuroblastoma may behave in an almost benign way, with spontaneous regression in some infants, but the majority of older patients have high-risk disease, which is usually fatal, despite best current treatments. As a rare disease, international collaboration is essential to run clinical trials of adequate statistical power to answer important questions in a reasonable time frame. High-risk disease requires multimodality therapy including chemotherapy, surgery and radiotherapy as well as biological and immunological treatments for optimal outcomes. Innovative treatment approaches, sometimes associated with appreciable toxicity, offer hope for the future but, despite parental wishes, cannot be generally implemented without adequate assessment in clinical trials.
authors: Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK.
authors: Jennifer
authors: J
authors: Gains
authors: Henry
authors: H
authors: Mandeville
authors: Nicholas
authors: N
authors: Cork
authors: Penelope
authors: P
authors: Brock
authors: Mark
authors: M
authors: Gaze
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D009503:Neutropenia / Q000209:etiology; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D035583:Rare Diseases; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents