This week's artwork was donated by Gavin, a pediatric cancer patient who received treatment at The Children's Hospital of Philadelphia . The prognosis and treatment of recurrent or progressive neuroblastoma depend on the site and extent of the recurrence or progression and on the previous therapy.
Recurrence is usually widespread and prognosis poor despite additional intensive therapy.
Unlike at initial presentation, central nervous system involvement is common. Most commonly, there is inward compression of the brain from cranial metastases, but meningeal and isolated intracranial metastasis can occur. Early recognition and treatment of central nervous system involvement may result in reduced neurologic impairment. The selection of further treatment depends on many factors, including the site of recurrence and previous treatment as well as individual patient considerations. Clinical trials are appropriate and should be considered.