Neuroblastoma Program

The Neuroblastoma Program at Dana-Farber/Boston Children's Cancer and Blood Disorders Center treats infants and young children with newly diagnosed and relapsed or hard-to-treat neuroblastoma, a cancer that begins in nerve tissue. Specialists in our program are renowned for treating the most complex cases, as well as for their expertise in delivering leading-edge treatments.

Dana-Farber/Boston Children’s is an integrated pediatric hematology and oncology partnership between Dana-Farber Cancer Institute and Boston Children's Hospital. We offer the full spectrum of services that are needed for diagnosis, treatment and ongoing care of even the rarest and hard-to-treat conditions in one specialized program.

The Neuroblastoma Program is the only center in New England and one of only a few in the country to offer therapy with I-131 MIBG, a compound that is absorbed by certain types of nerve tissue, including neuroblastoma cells. Our physicians use it to deliver targeted radiation therapy to neuroblastoma cells to treat high-risk, relapsed or refractory neuroblastoma.

Patient care teams include a pediatric oncologist who specializes in the treatment of neuroblastoma and works closely with pediatric surgeons, hematology nurses, pediatric oncology nurse practitioners, imaging specialists, pathologists, and stem cell transplant physicians.

Through our work with the Children’s Oncology Group and the New Approaches to Neuroblastoma Therapy Consortium, we offer the most phase I clinical trials in New England for children with recurrent neuroblastoma.

How we approach neuroblastomas

Our doctors perform a variety of tests to diagnose neuroblastomas. Tests may include a 24-hour urine test to measure the amount of certain chemical products made by the tumor, cytogenetic analysis to check for certain changes in chromosomes, and bone marrow aspiration and biopsy to look for signs of cancer. We also use imaging studies — X-rays, CT and MRI scans, and ultrasound—to evaluate the primary tumor and determine if it has spread. A procedure called an MIBG scan uses a radioactive molecule to help our doctors detect neuroblastomas. Many of these tests can also be used to stage the disease.

Treatment of neuroblastomas depends on the patient’s age at diagnosis, stage of the disease, location of the tumor, shape and structure of the tumor, and if it has spread elsewhere in the body. Standard treatments include surgery to remove the tumor, followed by local radiation therapy and high-dose chemotherapy to kill any remaining cancer cells. Biologic therapies may be used to boost or restore the body’s natural defense against cancer cells. Newer treatments include targeted therapies that attack specific cancer cells without harming nearby healthy cells and high-dose chemotherapy with stem cell transplant to replace blood-forming cells destroyed by cancer treatment. We also use a vitamin-like drug, called 13-cis retinoic acid, to slow the cancer’s ability to make more cells.

Our areas of research for neuroblastoma

Research is a top priority at Dana-Farber/Boston Children’s, and our physicians work continuously to translate laboratory findings into clinical therapies. We sponsor clinical trials for newly diagnosed neuroblastoma patients through the Children’s Oncology Group (COG) and, through COG and the New Approaches to Neuroblastoma Therapy Consortium, Dana-Farber/Boston Children’s offers the most Phase I clinical studies in New England for children whose disease has recurred.

Metaiodobenzylguanidine (MIBG) Therapy

We were the first hospital in New England to offer MIBG therapy to treat neuroblastoma, and are currently one of only a handful of hospitals in the country to provide this therapy. Metaiodobenzylguanidine (MIBG) is a compound that can be combined with radioactive iodine (131I) to deliver targeted radiation therapy to treat high-risk neuroblastoma.