Recent developments in the management of neuroblastoma

Neuroblastoma was first described in 1864 by Virchow. For the next 100 years, the primary approach to these patients was predominantly surgical resection. With the advent of multimodal adjuvant treatments using chemotherapy and irradiation in the 1950s and 1960s, coordination of multispecialty therapeutic interventions became important. By the late 1970s, effective neoadjuvant chemotherapeutic regimens enabled some inoperable tumors to be completely removed at the time of "second look" procedures. In the 1980s, advances in tumor biology and imaging gave new insight and novel prognostic indicators which helped determine the course of therapy. In the 1990s, treating poor risk patients with extremely high dose chemotherapy, irradiation, and allogeneic or autologous bone marrow rescue with or without surgical resection may finally improve the survival of these children.