Neuroblastom i Wilmsov tumor - standard liječenja

Abstract

The paper presents the basic characteristics and standard of treatment for neuroblastoma and Wilms tumor. The age at which these tumors appear is related to an earlier age. Neuroblastoma occurs slightly more often in boys, while nephroblastoma occurs slightlymore often in girls. The localization and stage of the disease define the clinical presentation. Neuroblastoma occurs more often as a metastatic disease with the possibility of developing a paraneoplastic syndrome, while Wilms tumor occurs more often as a localized disease. After the initial diagnosis, which determines the stage and risk of the disease, neoadjuvant chemotherapy is started. After the reevaluation, an operation follows, followed by postoperative chemotherapy. Nephrectomy is still used in the operative treatment of unilateral Wilms tumor. The residual kidney tissue is preserved in the bilateral Wilms tumor and an individual approach is implemented. Low-risk neuroblastoma can be treated with observation, chemotherapy, and surgery. Megatherapy and autolo-gous stem cell transplantation are used in the treatment of high-risk neuroblastoma, followed later by immunotherapy and retinoid therapy. Radiotherapy is used in advanced stages of Wilms tumor and in high-risk neuroblastoma. The use of the radioactive isotope meta-iodobenzylguanidine (MIBG) is also possible in the treatment of neuroblastoma. Rapid diagnosis and intensity of treatment defined by the risk of tumor disease with the use of appropriate supportive therapy are the basis of care for neuroblastoma and Wilms tumor.