Related Experiment Video
Updated: Aug 17, 2026
PET and MRI Guided Irradiation of a Glioblastoma Rat Model Using a Micro-irradiator
Published on: December 28, 2017
Palliative radiotherapy in children with neuroblastoma
1Department of Radiation Oncology, The University of Iowa College of Medicine, Iowa City, Iowa, USA. arnold@radonc.emory.org
Insights
External beam radiation therapy effectively palliates metastatic neuroblastoma in children. This treatment offers significant symptom relief and improves quality of life for patients with bone, soft tissue, brain, and liver metastases.
Area of Science:
- Oncology
- Pediatric Oncology
- Radiation Oncology
Background:
- Neuroblastoma is a common childhood cancer with metastatic potential.
- Limited data exists on the efficacy of external beam radiation therapy (EBRT) for palliative care in metastatic neuroblastoma.
Purpose of the Study:
- To evaluate the effectiveness of palliative radiotherapy in managing metastatic neuroblastoma in children.
- To assess response rates and survival outcomes for different metastatic sites treated with EBRT.
Main Methods:
- Retrospective review of 29 children with 53 metastatic sites treated with palliative radiotherapy between 1960 and 2000.
- Categorization of metastatic sites into soft tissue (Group I), bone (Group II), brain (Group III), and hepatic (Group IV).
- Assessment of treatment response based on tumor shrinkage (Groups I, III, IV) and pain relief (Group II).
Main Results:
- Significant palliation was observed across all metastatic sites.
- Group I (soft tissue): 77% partial or complete response.
- Group II (bone): 79% partial or complete response with pain relief.
- Group III (brain): 4/5 children showed neurological improvement.
- Group IV (hepatic): 2/3 patients had improved respiratory status.
Conclusions:
- External beam radiation therapy is an effective palliative treatment for symptomatic metastatic neuroblastoma in children.
- Radiotherapy provides substantial symptom control and improves outcomes for various metastatic sites.
- Further research into optimal palliative radiotherapy strategies for pediatric neuroblastoma is warranted.
Abstract:
Limited information is available regarding the efficacy of external beam radiation therapy in the palliation of metastatic disease from neuroblastoma. From 1960 to 2000, 29 children with 53 metastatic sites received palliative radiotherapy. There were 26 soft tissue (group I), 19 bone (group II), 5 brain (group III), and 3 hepatic (group IV) treated sites. Median radiotherapy doses for groups I, II, III, and IV sites were 2000, 2000, 2400, and 450 cGy, respectively. For group I sites, complete response was complete disappearance of mass, partial response was > or =50% resolution of mass, no response was <50% resolution or < or =25% progression of mass, and progressive disease was >25% progression of mass. For group II sites, complete response was complete pain relief without medication, partial response was > or =50% pain relief with or without medication, no response was <50% change in pain with medication, and progressive disease was increase in pain and/or medication. Median survival was 2.5 months after palliative radiotherapy. For group I sites, complete response was seen in 1 (4%) while partial response was documented in 19 (73%). Duration of response was until death in 18 responders (90%); 2 patients relapsed with an increasing soft tissue mass at 5 months and 1 year after palliative radiotherapy. For group II sites, complete response was seen in 8 (42%) while partial response was documented in 7 (37%). Duration of response was until death in 14 responders (93%); 1 patient had relapse of pain 1 year after palliative radiotherapy. For the 5 group III children, the median survival was 2.5 months with a range of 2 days to 13 months. Four children had neurological improvement after cranial radiotherapy; one patient progressed and died secondary to neurological compromise 2 days after radiotherapy. For the 3 group IV sites, 2 had improvement in respiratory status after radiotherapy, whereas 1 progressed despite doxorubicin, cyclophosphamide, and radiation. The only patient who survived had a stage IV-S neuroblastoma with liver metastases and is alive 13 years after hepatic irradiation. Radiotherapy is an effective treatment for palliation of symptomatic metastatic disease in children with neuroblastoma.
