Prognosis and chances of survival for children with neuroblastoma
Neuroblastoma- a malignant tumor of childhood that arises from sympathetic nerve tissues. The most often observed in children under 4 years old, in adults - a rarity. It is on the third place after leukemia and cancerous neoplasms of the central nervous system.
Onkozabolevanie arises from the adrenal medulla, can also be observed in the neck, chest or spinal cord.
Biological subtypes of neuroblastoma
Based on biological studies, these types of neuroblastoma are established:
- Type 1: characterized by loss of whole chromosomes. It is expressed by the neutrophin receptor TrkA, prone to sudden regression.
- Type 2A: contains copies of altered chromosomes, which are often found in the diagnosis and relapse of the disease.
- Type 2B: has a mutated MYCN gene, which leads to disruption in the regulation of cellular signaling and uncontrolled proliferation into neuroblast.
Neuroblastoma in children: causes
Almost nothing is known about what causes the development of neuroblastoma in children. There is no evidence and parental impact on the occurrence of neuroblastoma in a child. Only 1% to 2% of patients with neuroblastoma have a family history. These children are less than 9 months old at the time of diagnosis.
About 20% of children develop a multifocal primary neuroblastoma.
It is believed that the main cause of this oncological disease are germline mutation lines in the ALK gene. Family neuroblastoma is rarely associated with a congenital hypoventilation syndrome.
Neuroblastoma in children: symptoms and signs
A frequent sign of manifestations of neuroblastoma in a child is its presence in the abdominal cavity. Symptoms of cancer are caused by a growing tumor and metastases:
- exophthalmos and periorbital bruise;
- bloating: may occur due to respiratory failure or due to massive metastases in the liver;
- metastasis in the bone marrow;
- paralysis. Because of its origin in the spinal ganglions, neuroblastomas through neural holes can invade the brain and compress it. In this case immediate treatment is used in the form of symptomatic compression of the spinal cord;
- watery diarrhea, which is due to the secretion of the peptide of the tumor;
- subcutaneous nodules on the skin. Neuroblastoma can release subcutaneous metastases of bluish color.
Neuroblastoma in children: diagnosis
Visualization of primary tumor mass:
It is usually done with computer or magnetic resonance imaging with contrast. Paraspinal tumors that may pose a threat to spinal cord compression are imaged by MRI.
Collection of urine within 24 hours:
This study helps determine the amount of certain substances in the body. An increased level of homovaniline and vanillin-mandelic acids may be a sign of neuroblastoma in a child.
With neuroblastoma, a large number of dopamine and norepinephrine hormones are observed.
A test in which samples of blood or bone marrow cells are studied under a microscope to determine changes in chromosomes.
The bone marrow examination and general biopsy help to identify tissue cancer and its prevalence.
Stages of children's neuroblastoma
Malignant neoplasm is located only in one area and can be completely removed during surgery.
Includes stages 2A and 2B:
- 2A foresees the presence of a tumor in one area, but it can not be completely removed during surgery;
- 2B: the neoplasm is located in one segment, it can be completely excised, but the cancer cells are found in the lymph nodes.
One of the following conditions is foreseen:
- Cancer formation can not be completely removed. In addition, the tumor already had time to transfer to the other side of the body, as well as metastasis to the nearest lymph nodes;
- Oncology only in one part of the body, but the malignant process itself was transmitted to the lymph nodes on the other side of the body;
- a tumor in the middle of the body and spread to tissues or lymph nodes on both sides of the trunk. Therefore, neuroblastoma can not be surgically removed.
It is divided into stages 4 and 4S.
At the 4th stage, the tumor metastasizes to distant lymph nodes, skin and other parts of the body.
At stage 4S it is worth paying attention to the following conditions:
- child up to 1 year;
- cancerous lesions have spread to the skin, liver and / or bone marrow, but not to the bone itself;
- Cancer cells can be found in the lymph nodes near the primary tumor.
How to treat neuroblastoma in children?
Since oncological diseases in children are infrequent, different therapeutic options should be considered and undertaken:
One of the most acceptable options for treating neuroblastoma in children. However, it gives 100% effectiveness only in the first and in part in the second stage of the malignant process.
In the case of treatment of neuroblastoma in children, both external radiation and internal radiation can be involved. The method depends on the oncological stage.
The use of drugs to damage cancer cells or stop their division. Antitumor drugs enter the general bloodstream and can reach atypical spread throughout the body (systemic chemotherapy).
Monoclonal antibody therapy
This treatment of neuroblastoma in children is carried out with the help of special antitumor mechanisms, derived from the cells of the immune system in a laboratory way. They help to differentiate normal and atypical tissues. Antibodies attach to substances and kill cancer cells, blocking their growth and spread.
Neuroblastoma in a child: prognosis and chances of survival
Over the past 30 years, the 5-year survival rate for children with neuroblastoma in children under 1 year has increased from 86% to 95%.
For patients aged 1 to 14 years, the prognosis improved from 34% to 68%.
A general 5-year survival rate for small patients diagnosed with "neuroblastoma"In recent years, increased from 46% to 71%..