Practical Aspects of Targetted Radiotherapy with mIBG

Abstract

Advances in the management of neuroblastoma have been made in several different areas over the last few years. Mass screening programmes have been developed for the detection of asymptomatic neuroblastoma in children under 2 years of age. These programmes are based on the measurement of urinary catecholamines. Prognosis has been related to histopathological grading, measurement of substances in serum such as serum ferritin and neuron-specific enolase, and amplification of n myc. Specific immunological markers have facilitated the diagnosis of minimal bone marrow disease and made differential diagnosis from other small round-cell tumours more reliable. Modest improvements in survival have been achieved by combinations of newer chemotherapy agents in induction programmes, and high-dose chemotherapy and autologous bone marrow transplantation as consolidation therapy (Appendix B). However, despite these advances, long-term survival remains poor in children over 1 year of age with widespread disease at diagnosis.