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Neuroblastom (baza (https://www.youtube.com/watch?v=42-ctkObaAc),…
Neuroblastom
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Neuroblastoma
Management:
- surgery, full excision
- chemo and rad
- common recurrence- OP, pa kemoth (ciklo+Topo), radioizotoski MIBG, mioablativna kemoth
stadij, dob, biologija tumora
3 skupine
niskorizična (12 tj kemoth), SREDNJE RIZIČNA (24 TJ)
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visoko rizični(st III, IV, myc amp, nediferencirani)
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prije RT na primarni tumor ili reziduu pa plus 3. mijeloablativna kemoth-BuM (busulfan, melfalan) ili poslije
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- zračenje cijelog tijela+presadba KS
- oprovak + 6 mjeseci 13-cis retinoična kiselina
Diagnostic:
- CT scan
- MRI preferred if spinal inv
- nuclear med scan-MIBG-dijagnoza, procjena učinka terapije
- CMP & CBC, VMA, HVA
- Bone marrow studies
Clinical:
- Abdominal mass or swelling
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Epi:
- 2nd most common
- embrionalni tumor from the neural crest
- Peaks before 2 yoa
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