Neuroblastoma

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Focused Ultrasound Therapy

Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with neuroblastoma. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces a variety of therapeutic effects that could potentially enable neuroblastoma to be treated without surgery.

The mainstay of treatment for neuroblastoma is surgical resection coupled with chemotherapy. However, many patients do not respond adequately to chemotherapy and commonly relapse. Furthermore, most long-term survivors suffer adverse effects from their treatment. 

For certain patients, focused ultrasound ablation – to kill tumor cells – could provide a non-invasive alternative to surgery with less risk of complications and lower cost. Focused ultrasound-induced hyperthermia – moderate heating of tissue that is below the threshold for cell death – has the potential to increase blood flow to the tumor and enhance the local delivery of chemotherapy, thereby minimizing its adverse effects.

Potential advantages as compared to current treatments:

  • Focused ultrasound is non-invasive and radiation-free – no incisions, holes in the skull, electrodes in the brain – and therefore has reduced risk for infection and blood clots. 
  • Precise targeting minimizes damage to non-targeted healthy brain.
  • Treatment can be conformed to a wide variety of shapes and sizes.
  • Tissue temperature can be monitored in real-time using magnetic resonance imaging (MRI).
  • Treatment can be a complement to drug therapy, enabling effective treatment with lower doses of drugs and minimal toxicity.

Preclinical Laboratory Studies

Early-stage pre-clinical studies suggest that focused ultrasound may play a beneficial role in the treatment of unresectable neuroblastoma.  In one study, mice with neuroblastoma were treated with chemotherapy, focused ultrasound plus chemotherapy, or focused ultrasound alone. Following treatment, 53% of mice treated with focused ultrasound and 80% of mice treated with focused ultrasound plus chemotherapy were cured with no evidence of tumor at 200 days, versus 100% fatality at 45 days in the control group and in mice treated with just chemotherapy.

Additional Information

Children’s Neuroblastoma Cancer Foundation

Notable Papers

Shim J1, Staruch RM2,3, Koral K2, Xie XJ4, Chopra R2,5, Laetsch TW6,7. Pediatric Sarcomas Are Targetable by MR-Guided High Intensity Focused Ultrasound (MR-HIFU): Anatomical Distribution and Radiological Characteristics. Pediatr Blood Cancer. 2016 Oct;63(10):1753-60. doi: 10.1002/pbc.26079. Epub 2016 May 19.

S. Wang, V. Frenkel, and V. Zderic, “Optimization of pulsed focused ultrasound exposures for hyperthermia applications.,” J. Acoust. Soc. Am., vol. 130, no. 1, pp. 599–609, Jul. 2011. 

H. Matsumoto, “Revisiting sensitization mechanisms in cancer thermochemotherapy.,” Fukuoka igaku zasshi = Hukuoka Acta medica, vol. 100, no. 4, pp. 95–103, Apr. 2009.

Yang R, Reilly CR, Rescorla FJ, Sanghvi NT, Fry FJ, Franklin TD Jr, Grosfeld JL. Effects of high-intensity focused ultrasound in the treatment of experimental neuroblastoma. J Pediatr Surg. 1992 Feb;27(2):246-50


 

     

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