ESTRO 2024 - Abstract Book


Clinical - Paediatric

ESTRO 2024

year survival rate was 75%, as shown in Figure 1. In the subgroup in which irradiation was used as the initial treatment approach, 47 of 68 patients (69%) responded to treatment.

No severe toxicity cases were observed after the current low-dose radiation therapy. However, one case of induced secondary malignancy was reported. Our investigation also highlighted that contemporary concerns about the toxicity of radiation therapy in patients with neuroblastoma 4S are rooted in the literature that preceded the 1980s. During this era, the prevailing standard treatment involved orthovoltage irradiation with an AP-PA field orientation and doses exceeding 2000 rad. All documented cases of liver failure, renal insufficiency, or postural defects occurred after significantly higher doses compared to those used in the current standard low-dose radiotherapy.


Radiation therapy is an effective treatment modality for hepatomegaly in patients with neuroblastoma 4S, with a success rate of approximately 80%. A low dose ranging from 450 to 600 cGy does not cause toxicity related to the kidneys, liver, or postural defects. Considering the life-threatening risks associated with hepatomegaly in patients with neuroblastoma 4S, radiotherapy should be viewed as a viable and potentially life-saving treatment option, especially for those who do not respond to standard treatments.

Keywords: neuroblastoma 4S, hepatomegaly, toxicity


1. Schleiermacher G, Rubie H, Hartmann O, Bergeron C, Chastagner P, Mechinaud F, Michon J. Treatment of stage 4s neuroblastoma – report of 10 years’ experience of the French Society of Paediatric Oncology (SFOP). Br J Cancer 2003 Aug;89(3):470–476. doi: 10.1038/sj.bjc.6601154

2. Matthay KK. Stage 4S neuroblastoma: what makes it special? J Clin Oncol 1998 Jun;16(6):2003–2006. doi: 10.1200/JCO.1998.16.6.2003

3. Evans AE, Baum E, Chard R. Do infants with stage IV-S neuroblastoma need treatment? Arch Dis Child 1981 Apr 1;56(4):271–274. doi: 10.1136/adc.56.4.271

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