The Role of Preoperative Adjuvant Treatment in the Management of Esthesioneuroblastoma: The University of Virginia Experience

Rs, Polin; Jp, Sheehan; Ag, Chenelle; Muñoz, Edwin L.; Larner, J; Cd, Phillips; Rw, Cantrell; Er, Laws; Sa, Newman; Pa, Levine; Ja, Jane

doi:10.1097/00006123-199805000-00045

Cited by 131 publications

(129 citation statements)

References 22 publications

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“…Among the 37 treatment studies, analysis was restricted to 26 because seven articles were repeated reports probably on the same patients, 16,59,61,67,[74][75][76] and four 20,22,25,26 only covered specific aspects of the treatment of ENB. Data extracted from the studies were the total number of patients, the staging system used, the patients' distribution by stage and by histological grade, and the type of treatment.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…In addition, tumour shrinkage after chemotherapy has been correlated with survival. 74,75 We emphasise that recurrence can occur years after the completion of treatment, even more than 10 years later. 2,7,64 Therefore, long-term follow-up is needed, although the exact frequency of visits and the necessity for radiological studies have not been precisely studied.…”

Section: Prognosismentioning

confidence: 99%

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Esthesioneuroblastoma: a meta-analysis and review

Dulguerov

Allal

Calcaterra

2001

The Lancet Oncology

541

698

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Our objective was to review recent developments in diagnosis, staging, and treatment of esthesioneuroblastoma (ENB). A meta-analysis of publications between 1990 and 2000 was carried out, and studies were classified according to their main subject: origin/aetiology of ENB, histopathological diagnosis, and treatment. Data so far point to the basal progenitor cells of the olfactory epithelium as the origin of ENB. Histopathological diagnosis remains difficult and is based on results of antigen expression detected through a panel of antibodies by immunohistochemistry. RT-PCR of HASH expression could be a specific marker of ENB. Overall and disease-free survival at 5 years averaged 45% (SD 22) and 41% (SD 21) in the studies included in the meta-analysis. Survival in Hyams' grades I-II was 56% (SD 20) compared with 25% (SD 20) in grades III-IV (odds ratio 6.2). In patients with metastases in cervical lymph nodes (on average 5% of the total) survival was 29%, compared with 64% for patients with N0 disease (odds ratio 5.1). Survival according to treatment modalities was 65% for surgery plus radiotherapy, 51% for radiotherapy and chemotherapy, 48% for surgery, 47% for surgery plus radiotherapy and chemotherapy, and 37% for radiotherapy alone. The histopathological grading according to Hyams and the presence of cervical lymph-node metastases emerged as prognostic factors. A combination of surgery and radiotherapy seems to be the optimum approach to treatment. The exact role of chemotherapy in treatment protocols is still unclear. The role of elective neck dissection is unclear

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Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Esthesioneuroblastoma: a meta-analysis and review

Dulguerov

Allal

Calcaterra

2001

The Lancet Oncology

541

698

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“…10,12 Second, platinum-based regimens commonly are used for recurrent ENB, the largest experience of which (to our knowledge) was reported from the Mayo clinic. 3,5,12,13 In that study, 10 patients were reported, half of whom responded to salvage chemotherapy with a median duration of response of 9.5 months. 13 This experience is similar to the current study and suggests that meaningful palliation is possible in patients with ENB and CNS metastases utilizing a combined modality approach.…”

Section: Discussionmentioning

confidence: 98%

“…3,5,12,13 In that study, 10 patients were reported, half of whom responded to salvage chemotherapy with a median duration of response of 9.5 months. 13 This experience is similar to the current study and suggests that meaningful palliation is possible in patients with ENB and CNS metastases utilizing a combined modality approach. Whether other chemotherapy regimens used for the treatment of PNETs such as chronic oral etoposide or autologous bone marrow transplantation may prove useful for recurrent ENB involving the CNS is uncertain but warrants investigation.…”

Section: Discussionmentioning

confidence: 98%

Treatment of intracranial metastatic esthesioneuroblastoma

Chamberlain

2002

Cancer

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BACKGROUNDEsthesioneuroblastoma (ENB) is an uncommon tumor that may metastasize to the central nervous system (CNS). To the authors' knowledge there is no current consensus regarding treatment. The current study was conducted to determine the toxicity and response rate of combined modality therapy in the treatment of patients with ENB metastatic to the brain.METHODSSix patients (2 men and 4 women) ranging in age from 47–61 years (median age, 53.5 years) with ENB had clinical and neuroradiographic evidence of CNS metastases (brain parenchyma in 6 patients and leptomeningeal metastases in 3 patients). CNS‐directed therapy included radiotherapy (to the brain in three patients and to the spine in two patients) and chemotherapy (systemic in six patients and regional in three patients). Systemic chemotherapy was comprised of carboplatin, lomustine, and vincristine administered every 2 months. Patients were evaluated by neuroradiographic and neurologic examination every other month.RESULTSBetween 1–6 cycles of systemic chemotherapy were administered (median, 4.5 cycles). and 6–19 cycles of regional chemotherapy were administered (median, 17 cycles). Toxicity included aseptic meningitis (three patients), radiation enteritis (one patient), and ≥ Grade 3 (according to the National Cancer Institute Common toxicity Criteria) myelosuppression (four patients). Two patients required hospitalization for neutropenic fever and two patients required a transfusion (platelets in two patients and red blood cells in one patient). No treatment‐related deaths were reported. A partial response was achieved in four patients, and two patients demonstrated progressive disease. The median duration of response was 9 months (range, 2–12 months). Overall survival ranged from 3–13 months (median, 10.5 months). The cause of death was progressive parenchymal brain disease in three patients, systemic disease in two patients, and leptomeningeal disease in one patient.CONCLUSIONSIn the small cohort of patients in the current study, combined modality therapy was found to have modest toxicity and palliative efficacy. Cancer 2002;95:243–48. © 2002 American Cancer Society.DOI 10.1002/cncr.10679

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“…Although esthesioneuroblastoma is classified as a sensitive to chemotherapy tumor, neoadjuvant chemotherapy alone is not generally recommended [31]. Cisplatin-based chemotherapy regimens are advocated by several researchers especially in locally or regionally advanced and/or high grade cases [31,[38][39][40][41]. Hyams' grading is commonly adopted, as a significant prognostic factor, regarding the tumor's response to chemotherapy [40].…”

Section: Discussionmentioning

confidence: 99%

Olfactory Neuroblastoma Treated by Minimally Invasive Endoscopic Resection and Postoperative Adjuvant Radiotherapy: A Representative Case and an Updated Review of the Literature

Papacharalampous¹,

Kotsis²,

Vlastarakos³

et al. 2012

JCT

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This paper presents a case of an olfactory neuroblastoma, treated with minimally invasive endoscopic resection, followed by adjuvant radiotherapy and critically reviews the current literature with regard to diagnosis and management of such malignancies. Olfactory neuroblastoma is considered to be an uncommon malignancy of the nasal cavity. The tumor arises from the specialized sensory epithelial olfactory cells, normally situated at the upper part of the nasal cavity, including the superior nasal concha, the roof of the nose and the cribriform plate. The imaging modality of choice is computed tomography and magnetic resonance imaging. Combination of surgery and radiotherapy is considered to be the standard of care for primary site disease by the majority of researchers. Combined transfacial and neurosurgical conventional approaches are adopted in most cases, mainly due to the endocranial extension and the close anatomic relationship of esthesioneuroblastomas with the ethmoid roof and cribriform plate. However, recent literature supports that endoscopic resection correlates with similar oncologic control rates, compared with open surgery, when basic oncologic surgical principles are maintained.

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The Role of Preoperative Adjuvant Treatment in the Management of Esthesioneuroblastoma: The University of Virginia Experience

Abstract: Preoperative neoadjuvant therapy provides a valuable complement to radical craniofacial resection, leading to reduction in tumor burden. Patients experiencing reduction in tumor volume by neoadjuvant therapy demonstrate an improved prognosis.

Cited by 131 publications

References 22 publications

Esthesioneuroblastoma: a meta-analysis and review

Esthesioneuroblastoma: a meta-analysis and review

Treatment of intracranial metastatic esthesioneuroblastoma

Olfactory Neuroblastoma Treated by Minimally Invasive Endoscopic Resection and Postoperative Adjuvant Radiotherapy: A Representative Case and an Updated Review of the Literature

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