GPOH Guidelines for Diagnosis and First-line Treatment of Patients
                    with Neuroblastic Tumors, update 2025

Thorsten Simon; Theresa Thole; Sveva Castelli; Beate Timmermann; Danny Jazmati; Rudolf Schwarz; Jörg Fuchs; Steven Warmann; Jochen Hubertus; Matthias Schmidt; Julian Rogasch; Friederike Körber; Christian Vokuhl; Jürgen Schäfer; Johannes Hubertus Schulte; Hedwig Deubzer; Carolina Rosswog; Matthias Fischer; Peter Lang; Thorsten Langer; Kathy Astrahantseff; Holger Lode; Barbara Hero; Angelika Eggert

doi:10.1055/a-2556-4302

Klinische Pädiatrie, Table of Contents

Klin Padiatr 2025; 237(03): 117-140
DOI: 10.1055/a-2556-4302

Guideline

GPOH Guidelines for Diagnosis and First-line Treatment of Patients with Neuroblastic Tumors, update 2025

GPOH-Leitlinien für die Diagnose und Erstlinien-Behandlung von Patienten mit neuroblastischen Tumoren, update 2025

Authors

Thorsten Simon

¹Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
Theresa Thole

²Pediatric Oncology and Hematology, Charité University Hospital Berlin, Berlin, Germany
Sveva Castelli

²Pediatric Oncology and Hematology, Charité University Hospital Berlin, Berlin, Germany
Beate Timmermann

³Westgerman Protontherapycenter Essen, University of Duisburg-Essen, Duisburg, Germany
Danny Jazmati

⁴Department of Radiation Oncology, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
Rudolf Schwarz

⁵Department for Radiotherapy, UKE, Hamburg, Germany
Jörg Fuchs

⁶Pediatric Surgery and Urology, University of Tübingen, Tübingen, Germany
Steven Warmann

⁷Department of Pediatric Surgery, Charité University Hospital Berlin, Berlin, Germany
Jochen Hubertus

⁸Department of Pediatric Surgery, Marien-Hospital Witten, Witten, Germany
Matthias Schmidt

⁹Nuclear Medicine, University of Cologne, Cologne, Germany
Julian Rogasch

¹⁰Nuclear Medicine, Charité University Hospital Berlin, Berlin, Germany
Friederike Körber

¹¹Institut und Poliklinik für Radiologische Diagnostik, Kinderradiologie, University of Cologne, Cologne, Germany
Christian Vokuhl

¹²Pediatric Pathology, Institute for Pathology, University of Bonn, Bonn, Germany
Jürgen Schäfer

¹³Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
Johannes Hubertus Schulte

¹⁴Pediatric Oncology and Hematology, University of Tübingen, Tübingen, Germany
Hedwig Deubzer

²Pediatric Oncology and Hematology, Charité University Hospital Berlin, Berlin, Germany
Carolina Rosswog

¹Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany

¹⁵Experimental Pediatric Oncology, University of Cologne, Cologne, Germany
Matthias Fischer

¹Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany

¹⁵Experimental Pediatric Oncology, University of Cologne, Cologne, Germany
Peter Lang

¹⁴Pediatric Oncology and Hematology, University of Tübingen, Tübingen, Germany
Thorsten Langer

¹⁶Childrens’ Hospital, University Hospital Schleswig-Holstein Lübeck Campus, Lübeck, Germany
Kathy Astrahantseff

²Pediatric Oncology and Hematology, Charité University Hospital Berlin, Berlin, Germany
Holger Lode

¹⁷Pediatric Oncology and Hematology, University of Greifswald, Greifswald, Germany
Barbara Hero

¹Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
Angelika Eggert

²Pediatric Oncology and Hematology, Charité University Hospital Berlin, Berlin, Germany

Abstract

The clinical course of neuroblastoma is more heterogeneous than any other malignant disease. Many low-risk patients experience regression after limited or even no chemotherapy. However, more than half of high-risk patients die from disease despite intensive multimodal treatment. Precise disease characterization for each patient at diagnosis is key for risk-adapted treatment. The guidelines presented here incorporate results from national and international clinical trials to produce recommendations for diagnosing and treating neuroblastoma patients in German hospitals outside of clinical trials.

Zusammenfassung

Der klinische Verlauf von Neuroblastomen ist sehr variabel. Bei Patienten mit günstigem Risikoprofil werden regelhaft Spontanregression der Tumoren beobachtet. Bei Hochrisiko-Neuroblastom können dagegen nur ca. 50% der Patienten durch eine intensive multimodale Therapie geheilt werden. Eine exakte Risikoklassifizierung jedes einzelnen Patienten ist von entscheidender Bedeutung eine korrekte risikoadaptierte Therapie. Die hier vorgestellten Empfehlungen berücksichtigen Ergebnisse von nationalen und internationalen klinischen Studien und definieren den gegenwärtigen Standard für die Behandlung von Patienten mit Neuroblastomen in Deutschland außerhalb von klinischen Studien.

Keywords

neuroblastoma - treatment recommendation - ganglioneuroma - neuroblastic tumors - GPOH - pediatric oncology

Schlüsselwörter

Neuroblastom - Therapieempfehlungen - Neuroblastische Tumoren - Ganglioneurom - GPOH - Kinderonkologie

Full Text

References

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