Radiotherapy for neuroblastoma

Radiotherapy is a key part of treatment for many children with high‑risk neuroblastoma. It uses precise, high‑energy radiation beams to destroy cancer cells in areas where the disease first began or where it has spread. The aim is to reduce the chance of the cancer returning in those areas. Radiotherapy works by damaging the DNA inside cancer cells, making it harder for them to grow and survive. 

Radiotherapy is usually given after induction chemotherapy, surgery, and high‑dose chemotherapy, as part of the consolidation phase of treatment. 

When radiotherapy is used 

Your child’s clinical team will recommend radiotherapy based on: 

• The location of the original tumour 
• How well the tumour responded to chemotherapy and surgery 
• Whether cancer cells were found close to the edges of the removed tumour 
• Whether there is remaining disease in other parts of the body 

Radiotherapy is tailored to each child, and your child’s consultant will explain why it is being recommended as part of the overall treatment plan. 

How radiotherapy is given 

Radiotherapy is delivered using a specialist machine in a radiotherapy department. The treatment is: 

• Painless - your child will not feel the radiation during treatment 
• Very precise - it targets only the planned areas 
• Given daily (Monday to Friday) over 3-5 weeks for most high‑risk cases 
• Divided into small doses called fractions, which helps reduce side effects  

Because children must keep completely still, some may need general anaesthetic during treatment sessions. The radiotherapy team will discuss this with you in advance. 

Types of radiotherapy 

Most children receive photon radiotherapy, though proton beam therapy is used in some cases if it could reduce long‑term side effects or better protect surrounding tissues. Your child’s team will explain which approach is recommended and why. 

Read more about the different types of radiotherapy.

Planning radiotherapy 

Before treatment begins, your child will have a planning appointment, which may include: 

• A CT or MRI scan to map out the exact treatment area 
• Making a personalised mask or mould to help them stay in the same position 
• Meeting the radiotherapy team to understand what to expect 
• Discussing whether anaesthetic is needed 

Careful planning ensures the treatment is delivered accurately and safely.

Side effects 

Radiotherapy can cause side effects, but every child’s experience is different. 

Read more about the side effects of radiotherapy for neuroblastoma.

Your child’s treatment team will explain the side effects most relevant to your child and how these will be managed. 

Precautions and safety 

Radiotherapy is a safe and carefully controlled treatment. Your child will not be radioactive after external‑beam radiotherapy, and it is safe to be around other people. In rare cases where different types of radiation are used, your treatment team will advise if any specific precautions are needed. 

Animated video on radiotherapy for high-risk neuroblastoma

This video was produced as part of the SIOPEN High-Risk Neuroblastoma 2 Trial.