Esthesioneuroblastoma

Loy, Andrew H.; Reibel, James F.; Read, Paul W.; Thomas, Christopher Y.; Newman, Steven A.; Jane, John A.; Levine, Paul A.

doi:10.1001/archotol.132.2.134

Cited by 148 publications

(60 citation statements)

References 27 publications

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“…In a study reported by a group from the University of Virginia, patients with Kadish stage C received preoperative sequential chemotherapy (two cycles of vincristine + cyclophosphamide ± doxorubicin) and radiation therapy, followed by craniofacial resection. The 5-and 15-years survival rates reported for this group were 72% and 60%, respectively [12] , which are similar to other values reported without the use of chemotherapy [3,10] . There is limited experience in the metastatic setting owing to the rarity of this subset of patients.…”

Section: Discussionsupporting

confidence: 88%

“…The most frequent clinical manifestations are nasal obstruction (70%), epistaxis (46%), rhinorrhea, and headache. Anosmia, otalgia, and ocular pain are often present due to the neoplasm's invasion to adjacent structures [2,3,11,12] . During its growth, it extends to the skull base and can spread to the brain or spinal cord.…”

Section: Discussionmentioning

confidence: 99%

“…To improve the outcome, chemotherapy has been used in neoadjuvant and adjuvant treatments of locally advanced tumors; however, the survival data reflecting the outcome of chemotherapy are variable and chemotherapy's additional benefit, compared to just undergoing surgery or radiotherapy alone, remains uncertain [12,[33][34][35] . In a study reported by a group from the University of Virginia, patients with Kadish stage C received preoperative sequential chemotherapy (two cycles of vincristine + cyclophosphamide ± doxorubicin) and radiation therapy, followed by craniofacial resection.…”

Section: Discussionmentioning

confidence: 99%

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Esthesioneuroblastoma: A case with prolonged disease control

et al. 2016

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Esthesioneuroblastoma, a rare tumor arising from the olfactory vault, varies from being indolent to extremely aggressive. Owing to its rarity, the diagnosis, staging, and treatment of the disease are not well defined. According to a number of small observational retrospective studies and case reports, the disease's actual treatment involves surgery, radiotherapy, and/or chemotherapy (either as a single treatment or used in combination), depending on the disease's staging. Optimal treatment has not been standardized, particularly regarding the role of chemotherapy. We describe a case of advanced esthesioneuroblastoma with prolonged disease control, subjected to a multimodal therapy with surgery, radiotherapy, and chemotherapy, illustrating the benefits of this approach in managing a patient with esthesioneuroblastoma. Herein, we analyze the most important and controversial issues of this type of neoplasia.Keywords: esthesioneuroblastoma; nasal cavity; surgery; radiotherapy; chemotherapy

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Esthesioneuroblastoma: A case with prolonged disease control

et al. 2016

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“…With a median follow up time of 82.3 months, patients with ENB can experience disease recurrence even 10-years after completion of their initial treatment. 4, 20–22 As such, while we observed a trend towards improved neck control with ENI, this difference may become significant with longer follow-up. Unfortunately, overcoming the aforementioned limitations is difficult given the rarity and natural history of ENB.…”

Section: Discussionmentioning

confidence: 52%

The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck

Jiang

Mohamed

Fuller

et al. 2016

Practical Radiation Oncology

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Purpose Although adjuvant radiation to the tumor bed has been reported to improve the clinic outcomes of esthesioneuroblastoma (ENB) patients, the role of elective neck irradiation (ENI) in clinically node negative (N0) patients remains controversial. Here, we evaluated the effects of ENI on neck nodal relapse risk in ENB patients treated with radiotherapy as a component of multi-modality treatment. Methods and Materials Seventy-one N0 ENB patients irradiated at XXXXXXXXX between 1970 and 2013 were identified. ENI was performed on 22 of these patients (31%). Survival analysis was performed with focus on comparative outcomes of those patients who did and did not receive ENI. Results The median follow up time for our cohort is 80.8 months (range 6 – 350 month). Among N0 patients, 13 (18.3%) developed neck nodal relapses, with a median time to progression of 62.5 months. None of these 13 patients received prophylactic neck irradiation. ENI was associated with significantly improved regional nodal control at 5-year (regional control rate of 100% for ENI vs 82%, p < 0.001), but not overall survival or disease-free survival. Eleven patients without ENI developed isolated neck recurrences. All had further treatment for their neck disease, including neck dissection (n=10), radiation (n=10), or chemotherapy (n=5). Six of these 11 patients (54.5%) demonstrated no evidence of further recurrence with a median follow up of 55.5 month. Conclusion ENI significantly reduces the risk of cervical nodal recurrence in ENB patients with clinically N0 neck but this did not translate to a survival benefit. Multimodality treatment for isolated neck recurrence provides a reasonable salvage rate. The greatest benefit for ENI appeared to be among younger patients who presented with Kadish C disease. Further studies are needed to confirm these findings.

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“…Due to concern of late effects in children, doses in the range of 54 – 59.4 Gy are recommended [19]. In some adult series, doses as low as 50 Gy have been used without compromising outcomes [20]. Though some authors recommend prophylactic neck irradiation even in patients without cervical node involvement, this is controversial [16, 18].…”

Section: Discussionmentioning

confidence: 99%

Multimodality Treatment of Pediatric Esthesioneuroblastoma

Venkatramani

Pan

Furman

et al. 2015

Pediatr Blood Cancer

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Background Esthesioneuroblastoma (ENB) is a rare cancer of the nasal cavity in children. Radical surgery followed by post-operative radiation is considered the standard of care in adults. A similar approach in children can lead to significant long-term morbidity. Procedure A retrospective multi-institutional review of patients <21 years of age diagnosed with ENB between 1990 and 2014 was performed. Clinical features, treatment and outcome were obtained from the medical records. Results Twenty-four patients were identified; median age at diagnosis was 14 years (range 0.6 – 20 years). The majority (75%) were female. Headache was the most common presenting symptom, followed by nasal obstruction and epistaxis. Eight patients had Kadish stage B tumors and 16 had Kadish Stage C. Nine patients had metastatic disease. Gross total resection was achieved at diagnosis in eight patients and after neoadjuvant chemotherapy in four patients. Twenty-one patients received radiation therapy (45 Gy – 68.4 Gy). Thirteen patients received neoadjuvant chemotherapy with 84% objective response rate. Seven patients experienced disease progression or relapse; five in central nervous system, one local and one in cervical lymph node. Fifteen patients were alive at last follow-up. The 5-year disease free survival and overall survival were 74% and 73% respectively. Late effects were observed in 78% of long-term survivors. Four patients developed subsequent malignant neoplasms. Conclusions Pediatric ENB is a chemosensitive disease. Pre-operative chemotherapy based multimodal approach should be used in patients with advanced stage disease. Radiation therapy is effective for local control but lower doses should be considered in children.

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Esthesioneuroblastoma

Cited by 148 publications

References 27 publications

Esthesioneuroblastoma: A case with prolonged disease control

Esthesioneuroblastoma: A case with prolonged disease control

The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck

Multimodality Treatment of Pediatric Esthesioneuroblastoma

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