文章来源：向日葵儿童 作者：向日葵儿童 时间：2018-10-09
Question: If there is a postoperative residual tumor, could the patient live with the tumor?( For example, if there is a residual tumor in the spinal canal that not be operated, is the hope big for living with the tumor?)
Answer: Yes. Especially if the tumor is localized and has favorable biological features.
Question: Between the proton radiotherapy and other kind of radiotherapiy, which one is more suitable for neuroblastoma patients at present? What are their respective advantages and disadvantages?
Answer: There is no proven advantage at this time to proton beam radiotherapy versus more conventional IMRT.
Question: In the international is there any stage IV case that is cured by allotransplantation? What’s the difference between autotransplantation and allotransplantation and what’re their respective advantages?
Answer: All of the large Phase 3 Children’s Oncology Group trials have tested the efficacy or autotransplantion for children with high-risk neuroblastoma in the upfront setting. The stem cells are harvested form the patient after 2-3 cycles of induction chemotherapy and then re-infused at time of myeloablative autotransplantation to rescue the body from the effects of the lethal doses of chemotherapy.
Allo-transplantation (using a donor that is not “self”) has been tested mostly in the setting of relapse- there is very limited experience using this approach and many more side effects can be expected.
Question: What is the latest treatment for the children whose neuroblastoma stage IV have already showed recurrence? How is the effect of the treatment? How much is the cure rate (5-year survival rate) after recurrence?
Answer: There is no standard treatment for children with high-risk neuroblastoma who suffer a relapse. This needs to be individualized and often depends on the pattern of relapsed and disease burden. Approaches include I131MIBG therapy, targeted investigational therapies, and conventional approaches that utilized chemo/radiation and immunotherapy. There is a significant effort to perform molecular profiling on the tumor at relapse to see if there are targetable mutations in cancer genes for which there may be matched drugs that can be used (an example is crizotinib when there is an ALK mutation).
Question: If the children appear leaky gut and always can't eat or chemotherapy, it takes to several months to cure leaky gut, so whether there are other ways to control tumor progression?
Answer: Even in the setting of a “leaky gut,” chemotherapy should not be delayed in the setting of high-risk neuroblastoma. Every effort should be made to continue chemotherapy and to sue hyperalimentation (IV nutrition) until the gut heals.