Radiation Therapy for Neuroblastoma

Radiation therapy uses energy beams to destroy cancer cells. It’s typically used to treat advanced neuroblastomas that don’t respond to chemotherapy. It may also be used to shrink tumors that are pressing on nerves or the spinal cord prior to surgery, or to kill any cancer cells that remain after surgery. At Hassenfeld Children’s Hospital at NYU Langone, radiation oncologists work with your child’s oncologist to determine whether radiation therapy is an appropriate treatment.

Neuroblastoma tumors are typically located near major organs, such as the stomach and kidneys, and can press on the spinal cord. As a result, conventional external beam radiation, which can damage surrounding healthy tissue, is not typically used on children with this cancer. Doctors prefer to use more targeted types of radiation.

Intensity Modulated Radiation Therapy

This targeted radiation treatment uses X-rays, or beams of energy, to deliver radiation directly to a tumor while minimizing effects on the surrounding healthy tissue. MRI images of the tumor and the surrounding area are used to guide the doctor to the tumor.

Intensity modulated radiation therapy uses a linear accelerator, the same machine used in conventional radiation, but it delivers a dose of more targeted radiation based on the tumor’s size, shape, and location.

Proton Therapy

Proton therapy works by accelerating positively charged particles called protons to rapid speeds—nearly two-thirds the speed of light—and aiming them at cancer cells to damage their DNA, causing them to die. This allows doctors to deliver focused high doses of radiation directly to the neuroblastoma, with minimal damage to surrounding tissue in the body.

This 30- to 90-minute outpatient treatment requires daily sessions, five days a week, for one week to two months, depending on the neuroblastoma’s location, type, and size. Young children who need help lying still may require general anesthesia during treatment.

Managing Side Effects

Intensity modulated radiation therapy can cause reddened skin, like a sunburn, and fatigue. Other side effects depend where in the body radiation therapy is aimed. Your child’s radiation oncologist reviews potential side effects and how to take care of them prior to starting treatment.

Most radiation side effects are temporary and tend to disappear after treatment ends. Your child’s oncologist collaborates with the radiation oncologist, nurses, social workers, and child psychologists to help your child and other family members cope with the physical and emotional side effects of radiation therapy.