Esthesioneuroblastoma: Reflections of a 21‐Year Experience

Levine, Paul A.; Gallagher, Richard; Cantrell, Robert W.

doi:10.1097/00005537-199910000-00001

Cited by 142 publications

(182 citation statements)

References 39 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…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%

Esthesioneuroblastoma: a meta-analysis and review

Dulguerov

Allal

Calcaterra

2001

The Lancet Oncology

549

698

View full text Add to dashboard Cite

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

show abstract

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

Esthesioneuroblastoma: a meta-analysis and review

Dulguerov

Allal

Calcaterra

2001

The Lancet Oncology

549

698

View full text Add to dashboard Cite

show abstract

“…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%

“…1,2 The clinical course in patients with extensive disease often is marked by persistent recurrence despite attempts to resect or radiate with intent to cure. [3][4][5][6] Kadish et al developed a clinical staging system to categorize ENB (Stage A: tumor confined to the nasal cavity; Stage B: tumor confined to the nasal cavity and paranasal structures; and Stage C: tumor spread beyond the nasal cavity and paranasal sinuses). 1 Prognosis appears to correlate best with the extent of disease at the time of presentation as defined by the staging system of Kadish et al 1 Distant metastases are observed in 20% of Stage A patients, 30% of Stage B patients, and 50% of Stage C patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of intracranial metastatic esthesioneuroblastoma

Chamberlain

2002

Cancer

View full text Add to dashboard Cite

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

show abstract

“…4,5 Since its initial description in 1924, multiple institutions have developed treatment strategies that use various combinations of surgery, radiation therapy, and chemotherapy. 1,2,[6][7][8][9][10][11][12][13][14] Although no definitive regimen has been established, analysis of this collective experience demonstrates that multimodality therapy, particularly surgery followed by radiation, achieves the highest cure rates.…”

Section: Introductionmentioning

confidence: 99%

Esthesioneuroblastoma: An Update on the Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital Experience with Craniofacial Resection, Proton Beam Radiation, and Chemotherapy

Herr¹,

Lin²,

Curry³

et al. 2013

J Neurol Surg B

View full text Add to dashboard Cite

Objectives To update the Massachusetts General Hospital (MGH) and Massachusetts Eye and Ear Infirmary (MEEI) experience in the management of esthesioneuroblastoma (ENB) with multimodality therapy and to reassess treatment outcomes and complications in a larger cohort with longer follow-up times. Design A retrospective chart review. Setting A tertiary referral center. Participants All patients presenting with ENB and managed at the MGH and MEEI from 1997 to 2013. Main Outcome Measures Disease-free and overall survival. Results Twenty-two patients were identified with an average follow-up of 73 months. Ten patients presented with Kadish stage B disease and 12 with stage C disease. A total of six patients (27%) developed regional metastases. Treatment for all patients included craniofacial resection (CFR) followed by proton beam irradiation with or without chemotherapy. The 5-year disease-free and overall survival rates were 86.4% and 95.2%, respectively, by Kaplan-Meier analysis. Negative margins were a significant factor in disease-free survival. One patient experienced severe late-radiation toxicity. Conclusions ENB is safely and effectively treated with CFR followed by proton beam irradiation. The high incidence of regional metastases warrants strong consideration for elective neck irradiation. Proton beam radiation is associated with lower rates of severe late-radiation toxicity than conventional radiotherapy.

show abstract

Esthesioneuroblastoma: Reflections of a 21‐Year Experience

Cited by 142 publications

References 39 publications

Esthesioneuroblastoma: a meta-analysis and review

Esthesioneuroblastoma: a meta-analysis and review

Treatment of intracranial metastatic esthesioneuroblastoma

Esthesioneuroblastoma: An Update on the Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital Experience with Craniofacial Resection, Proton Beam Radiation, and Chemotherapy

Contact Info

Product

Resources

About