Background: Neuroblastoma (NB) is a type of cancer that often affects children. Surgical management of smaller tumors (those less than 5 cm in size) poses unique challenges, making it difficult to ensure thorough and effective treatment. The primary aim of our study is to develop and optimize a model for laser ablation specifically tailored for small NB tumors. Methods: Our research model involves graft tissue to test various characteristics after the fiber optic ablation process. These characteristics include the quality of laser beams, average power levels, and precise pulse timing. Results: The heated-laser ablation procedure employed a laser energy of 1.0 mJ and power of 1.0 kW. An optimal setting of a high-quality beam at 60 with 18.5 watts of power and a 2.5 ms pulse duration achieved an impressive tissue ablation rate of up to 95.8%. We also found that heated-laser is more significant than frozen-laser ablation for the efficiency of enhancements, including an optimal power, a 2-fold decrease of pulse time, and an increase to induce apoptosis (cell death) in cancer cells and alters the collagen structure in the tumor microenvironment. Conclusion: The proposed model may help optimize the development of this combined treatment method for solid tumors, particularly in the design parameters of the graft tissue.

Background/Objectives: High-risk neuroblastoma (HR-NB) is a major cause of cancer-related death among children. The review aims to discuss various biochemical and genetic traits of neuroblastoma (NB) used for the potential of cell-based therapies. Methods: A comprehensive search was performed through MEDLINE, PubMed, Scopus, and ScienceDirect using various combinations of “neuroblastoma”, “tumor microenvironment (TME)”, “immune cells”, “non-immune cells”, “hematopoietic stem cell transplantation (HSCT)”, “autologous stem cell transplantation (ASCT)”, “natural killer cells (NK)”, “chimeric antigen receptor T cells (CAR-T)”, “CAR-NKT”, “tumor infiltrating lymphocytes (TIL)”, “bioinformatics”, and “neuro-antigens” in the published papers over the last decade. Reviews, systematic reviews, and clinical trials related to children’s NB were selected. The final set included 106 articles of interest. Results: Recent studies have shown that TME is crucial in determining the malignancy, immune evasion, and drug resistance of NB. Innate immune or non-immune cells play important roles in shaping the NB TME. Depleting or reprogramming TME factors can improve the effectiveness of immunotherapy. A number of clinical trials have studied and showed feasibility of using ASCT, NK cells, CAR-T, and CAR-NKT cells in the adoptive therapy for HR-NB. However, an unambiguous evaluation of the effectiveness of cell-based technologies in the HR-NB therapy is still complicated due to the lack of large randomized trials. Conclusions: The reported small and non-randomized studies that demonstrated controversial results cannot prove, undoubtedly, the promising potential of the cell-based technologies including ASCT, NKs, CAR-T, and CAR-NKT cells. Further randomized clinical trials, using the same treatment, will help determine the role in the multimodal treatment for HR-NB.