Long-term musculoskeletal side effects in patients with neuroblastoma who have completed specific therapy (case reports and literature review)

Neuroblastoma (NB) is the most common extracranial solid tumor in children. The stratification of patients into risk groups has led to the development of therapeutic protocols with intensification of therapy in high-risk patients and minimal treatment, up to the complete abandonment of chemotherapy in patients with a potentially favorable long-term prognosis. The implementation of multimodal therapy in the intermediate/high-risk group patients significantly improved long-term survival rates. However, anticancer treatment inevitably leads to a wide range of undesirable effects and long-term consequences, including negative effects on the musculoskeletal tissue and teeth. The main factors leading to the pathology of the musculoskeletal system include chemotherapy, including high-dose chemotherapy with autologous hematopoietic stem cell transplantation, radiation therapy and other methods of treatment. In addition, the localization of a primary tumor and metastases creates a potential threat of the development of undesirable effects on the musculoskeletal system, including for patients from the observation group. The article presents a description of clinical cases of musculoskeletal toxicity in patients with NB who completed specific treatment with a literature review on this topic. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.