Neuroblastoma is the most common extracranial malignant solid tumor from the sympathetic nervous system in children, and 60% of childhood neuroblastomas have metastasized by the time of diagnosis. Neuroblastoma is usually located in the abdominal cavity, with the retroperitoneum accounting for 75%, the chest for 12%, the pelvis for 5%, the neck for 2%, and the spine for 1% of tumors, although in 5% of cases no etiology is found. Neuroblastoma has a diverse clinical presentation, reflecting its biological heterogeneity. The age of the patient at the time of tumor staging and diagnosis, as developed by the International Neuroblastoma NB Staging System, is the main prognostic factor closely related to survival, while abnormal tumor genes play a decisive role in tumor phenotype and prognosis, especially the amplification of the MYCN oncogene. Treatment planning is based on low, intermediate and high risk of tumor recurrence. Although most children with low-risk NB can be cured by surgery alone, less than 40% of children with high-risk NB survive >5 years despite aggressive treatment combining chemotherapy, surgery, high-dose chemotherapy with autologous hematopoietic stem cell transplantation, radiation therapy, and differentiation-inducing drugs (vincristine). For children with stage IV high-risk NB with tumors encircling large blood vessels, preoperative chemotherapy is used, followed by surgical resection after 2-4 courses if the tumor shrinks and is operable, followed by chemotherapy, followed by high-dose chemotherapy with autologous hematopoietic stem cell transplantation, and then local radiotherapy at the primary tumor site, as local radiotherapy can improve the local control rate in neuroblastoma with poor prognosis. There are 4 main prognostic factors for neuroblastoma: MYCN gene amplification, tumor stage and infiltration, age at presentation, and treatment, but also other factors exist that will be used in cases where classification is difficult. Chemotherapy is essential in the initial treatment strategy of neuroblastoma. In fact, 60% of children have metastases at the time of diagnosis and NB is a chemotherapy-sensitive tumor. For inoperable tumors (stage L2), chemotherapy can reduce the size of the tumor and make it eligible for surgery. The most frequently used agents are vincristine, cyclophosphamide, adriamycin, etoposide, and platinum salts, and high-dose intensive cycles of chemotherapy tend to have good rates of complete remission. In order to improve NB with poor prognosis to obtain complete or near complete remission rates, high-dose chemotherapy with carboplatin, etoposide, and marfalan is commonly used in Europe and in the United States in combination with bone marrow-derived or blood-derived stem cell transplantation, and it has been clearly shown that there is an association between drug dose, tumor response, and survival, demonstrating that high-dose chemotherapy with hematopoietic stem cell The relative effectiveness of these combined therapies will now be judged in Europe. Finally, children with high-risk NB complete 6 months of oral administration of retinoic acid derivatives, thereby promoting maturation of non-malignant cells that remain after stem cell transplantation. According to the INRG classification of neuroblastoma, the degree of tumor expansion is an important prognostic factor. In the absence of MYCN gene amplification, the prognosis of neuroblastoma metastases (M stage) is more severe than in the limited stage, and the MS prognosis is usually better in the absence of some complications related to tumor compression. Neuroblastoma is a radiation-sensitive tumor, and due to the continuous advancement of radiotherapy equipment in recent years, intensity-modulated radiation therapy under image guidance, the beam intensity section is tailored to the three-dimensional shape of the target area and the specific anatomical relationship between the vital organs and the target area, and various advanced imaging devices are used to monitor the tumor and normal organs in real time before and during the treatment of children, and the treatment conditions can be adjusted according to the changes in the location of the organs. The treatment conditions can be adjusted according to the change of organ location, so that the irradiation field can closely “follow” the target area, so that the treatment can be truly precise, thus reducing the complications of radiotherapy. In children with stage IV high-risk NB tumors surrounding large blood vessels, the prognosis is poor despite the combination of preoperative chemotherapy, surgery, postoperative chemotherapy and autologous hematopoietic stem cell transplantation with high-dose chemotherapy, radiotherapy and differentiation-inducing drugs (vincristine). Children with high-risk NB tumors encircling large blood vessels underwent preoperative chemotherapy, surgery, postoperative chemotherapy and intensive chemotherapy with HSCT followed by local radiotherapy, and relapsed 2 months after the completion of radiotherapy. The goal of surgery, either immediately or after preoperative chemotherapy, is to remove as much of the tumor as possible. Although preoperative chemotherapy shrinks the tumor and creates the conditions for surgery, stage III-IV high-risk NB is often seen with tumors encircling the aorta and/or vena cava, which are difficult to remove surgically, and surgery disrupts the blood supply, potentially preventing chemotherapy drugs from reaching the tumor and causing the perivascular area to become a refuge for the tumor, making tumor recurrence and metastasis possible. It becomes possible for tumor recurrence and metastasis. Therefore, radiation therapy should be performed before high-dose chemotherapy for autologous HSCT in children with postoperative high-risk NB, in order to increase the local control rate of tumor and kill the hidden tumor cells, thus reducing the probability of metastasis and increasing the efficacy of high-dose chemotherapy for autologous HSCT. To detect any missed metastases. When preoperative chemotherapy is not sensitive, local preoperative radiotherapy should be used to achieve a successful surgery.