What are the side effects of radiotherapy for neuroblastoma? 

Radiotherapy uses high energy radiation to destroy cancer cells. It can be effective in treating neuroblastoma, but it may also cause side effects. The type and severity of side effects depend on where radiotherapy is given, the dose, and your child’s age. 

Not all children will experience the same side effects. Your child’s healthcare team will monitor them closely during and after treatment and can help manage any problems that arise. 

Short-term side effects 

Short-term side effects often begin during radiotherapy or shortly after treatment finishes. These usually improve over time. 

Possible short-term side effects include: 

• Tiredness and feeling unwell: children often feel very tired and generally unwell during and after treatment. Rest and gentle activities can help. 

• Skin changes in the treated area, such as redness, soreness or sensitivity. 

• Hair loss where radiotherapy is given: this is usually temporary. 

• Nausea and vomiting or diarrhoea: these are common if the abdomen is treated but can usually be managed with medicines. 

• Loss of appetite: some children may need additional nutritional support, such as a nasogastric (NG) tube, if they are unable to eat enough. 

Your child’s team can suggest ways to manage these effects and will review your child regularly. 

Longer-term side effects 

Some side effects may develop months or years after radiotherapy finishes. The risk depends on factors such as your child’s age at treatment, the part of the body treated, and the radiation dose. 

Possible longer-term effects can include: 

• Changes in bone growth or development, particularly in young children. 

• Effects on nearby organs, such as the kidneys, lungs or liver, depending on the treatment area. 

• Hormone or growth problems if radiotherapy is near the brain or spine. 

• Fertility issues later in life, if reproductive organs are affected. 

Not all children will experience long-term side effects. Advances in radiotherapy planning are designed to reduce radiation exposure to healthy tissue as much as possible. 

Your child’s medical team should explain any potential risks clearly and discuss how these are balanced against the benefits of treatment. 

Support and follow up 

Children who receive radiotherapy for neuroblastoma are followed up long term so that any late effects can be identified and managed early. If you have concerns at any stage, you should speak to your child’s treatment team.