Radiotherapy to the upper abdomen for Neuroblastoma
This page has been written to give you general information and answer some of the questions you may have about the side effects of radiotherapy.
We hope you will find this helpful.
Leaflet to download
You can also download the information on this page as a PDF leaflet:
We give radiation treatment (radiotherapy) in addition to surgery and chemotherapy because the disease may come back if we do not. The treatment has to be planned with great care and it is successful for many, but unfortunately not all, patients.
The total radiation dose has to be spread out over quite a long time to make the individual treatments safe. We give treatment every day for about two to four weeks (usually excluding weekends and bank holidays). At each session, the patient spends about ten minutes in the treatment room but most of this time is spent getting him/her into the right position.
Radiotherapy does not hurt, the machine does not touch the patient and it is rather like having an ordinary x-ray. We have to treat the whole area accurately, which means that the patient must lie very still. We decide whether the patient lies on their front or their back depending on the best way of giving the treatment. Lying still can be very difficult for some children, particularly young ones, so occasionally we have to use a general anaesthetic. A buzzing noise may be heard when the machine is working.
There are always side effects. We can relieve most of them but sometimes not completely. Some of the side effects happen immediately, some of them happen soon after we finish treatment and some take a longer time to show.
Side-effects after treatment
Long-term side effects
These are the hardest to predict and unfortunately, when they do happen, they are permanent.
The radiation may affect the growth of the back bones and ribs in the radiation area. As only a small part of the spine is treated it is unlikely to have a significant effect on final height. However because only one side of the tummy is treated one loin can look thinner than the other and the waist may be narrow.
The testicles are usually well away from the treated area and in most cases will be unaffected by the radiotherapy. The ovaries can be close to, or occasionally within the treatment area and if they are fertility may be affected. This will need to be discussed on an individual basis. Options for overcoming infertility can be discussed at the appropriate time.
Both radiotherapy and chemotherapy may affect the kidney. One kidney is usually (but not always) in the area we need to treat and may receive a dose that could affect its function in later life. We are careful to minimize the risk to the other kidney. Provided that the other kidney continues to work normally there should not be any symptoms. The function of the kidney and blood pressure will be carefully monitored at follow-up as problems can develop many years after treatment. The radiation dose we give is low and we would not expect any long-term bowel problems. However sometimes after surgery and radiotherapy the tissue surrounding the bowel can stick together (adhesions) and this can sometimes cause symptoms requiring surgery.
We are finding that, very rarely, children who have had treatment for one tumour can develop another type of tumour some years later.
During follow-up we will be looking out for all of these problems