Of the 106 patients, 11 (10.4%) developed brain metastasis, accounting for 20.0% of 55 patients with relapse
or progression. The age at initial diagnosis of the 11 patients ranged from 2 to 10 years (median 4 years), which
was younger than that of the patients without brain metastasis (median 5 years, range 1–10 years, P = 0.073). The
male to female ratio of the 11 patients was 8:3, which was not significantly different from that of the patients without
brain metastasis (P = 0.86). Patients with brain metastasis had higher lactate dehydrogenase levels than those
without brain metastasis, but the differences were not significant (P = 0.076). Eight patients died, and 3 patients
survived. The median interval from the initial diagnosis to the development of brain metastasis was 18 months (range
6–32 months). The median survival was 4 months (range 1 day to 29 months) after the diagnosis of brain metastasis.
The median interval from the manifestation of brain metastasis to death was 3 months (range 1 day to 11 months).
Conclusions: High-risk factors for brain metastasis in cases of neuroblastoma include bone marrow involvement and
a younger age at initial diagnosis. Nevertheless, multiple treatment modalities can improve disease-free survival.
Keywords: Neuroblastoma, Post treatment, Brain metastasis, Stage 4