Neoadjuvant chemotherapy in the setting of locally advanced olfactory neuroblastoma with intracranial extension

Aljumaily, Raid; Nystrom, J. Scott; Wein, Richard O.

doi:10.4081/rt.2011.e1

Cited by 9 publications

(3 citation statements)

References 17 publications

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“…Due to its low incidence, the optimal treatment remains unclear. Whereas the benefit of chemotherapy has been described in the literature 22 , 23 . The chemotherapy protocols and specific chemotherapeutic drugs selected to treat patients with ENB may vary for each individual patient; it is difficult to analyze and compare their therapeutic effects.…”

Section: Discussionmentioning

confidence: 99%

Exploration of the optimal treatment regimes for Esthesioneuroblastoma: a single center experience in China

Yuan¹,

Ye²,

Qiu³

et al. 2018

J. Cancer

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BACKGROUND: Esthesioneuroblastoma (ENB) is an uncommon neoplasm arising from the olfactory mucosa. The optimal treatment regimen for ENB remains unclear. This study aims to evaluate its clinical features, long-term outcomes and explore optimal treatment patterns.METHODS: Clinical data of consecutive 44 ENB patients were reviewed retrospectively. The correlation between clinical features and treatment approaches were analyzed, with several prognostic factors explored meanwhile.RESULTS: The age of onset of ENB showed a bimodal distribution, with peaks at 10~20 and 50~60 years. The median follow-up time was 84 months (range, 27~198 months).The 5-year overall and progression free survival rates were 42.7% and 39.1%, respectively, with 10-year rates of 28.9% and 21.7% respectively. Overall, 19 patients developed recurrent disease. Patients undergoing surgery combined with adjuvant radiotherapy had significantly higher 5-year overall survival (67.5% vs. 33.3%, P=0.043) and progress-free survival (60.0%vs. 18.7%, P=0.008) than those receiving other treatment approaches. No-Skin-involved ENB was associated with markedly better 5-year overall survival (45.5%vs.0 %, P=0.038) and progress-free survival (31.3% vs. 0 %, P=0.001) compared with skin-involved tumor.CONCLUSIONS: ENB is a rarely malignant tumor with high probability of locoregional recurrence and poor survival. Surgical resection followed by radiotherapy has been shown to achieve optimal local control and overall survival.

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Section: Discussionmentioning

confidence: 99%

Exploration of the optimal treatment regimes for Esthesioneuroblastoma: a single center experience in China

Yuan¹,

Ye²,

Qiu³

et al. 2018

J. Cancer

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“…At publication, PFS surpassed 8 months. 16 Palliative cytotoxic chemotherapy most commonly yields only modest and temporary symptom improvement and with the goal of less toxicity. 17 , 18 …”

Section: Discussionmentioning

confidence: 99%

Unexpectedly Durable Palliation of Metastatic Olfactory Neuroblastoma Using Anti-Angiogenic Therapy with Bevacizumab

Dunbar¹,

Pumphrey²,

Bidari

2012

Rare Tumors

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Olfactory neuroblastomas (ONBs) are rare malignant tumors that arise from olfactory epithelium and typically present with symptoms attributable to locally invasive disease. Kadish radiographic staging and Hyams' histopathologic grading are prognostic. Overall survival rates, averaging 60–70% at 5 years, remain limited by high rates of delayed loco-regional and distant progression. At initial presentation, the available evidence supports the use of multimodality therapy, historically surgery and radiation, to improve disease-free and overall survival. At recurrence/progression, the available evidence supports the use of therapy to improve disease control and symptoms (palliation), but patient heterogeneity dictates individualization of modalities. Although the ideal use of chemotherapy as a modality remains undefined, the available evidence supports it use, historically platinum-based, for palliation. However, recent insights into the molecular-genetic aberrations of ONBs, coupled with the emergence chemotherapeutic agents capable of targeting such aberrations, suggest an expanded role. The authors report a case of a 60 years-old man, heavily pre-treated for metastatic ONB, presenting with profound central-nerve-system and head-and-neck symptoms. He experienced unexpectedly durable palliation with Bevacizumab anti-angiogenic therapy. Additionally, he experienced localized palliation with an Ommaya reservoir. The authors review the literature regarding historical and emerging therapies for ONB to emphasize the needs for individualization and translational-clinical studies.

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“…Examples of malignancies where neoadjuvant therapy is often considered includes high-grade neuroendocrine carcinomas, squamous cell carcinoma, sinonasal undifferentiated carcinomas (SNUCs), and higher grade esthesioneuroblastomas. 6,8,[12][13][14][15][16] The use of IC for response-adjusted local therapy has been associated with improved survival, higher rate of organ preservation, and negative surgical margins. 6,12,13,17,18 While IC plays an important role in the histology-specific treatment of patients with sinonasal malignancies, the treatment of patients who present with neurological deficits or brain invasion (BI) remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Induction Chemotherapy for Sinonasal Tumors in Patients Presenting with Brain Invasion and/or Neurological Deficits

Brahimaj,

Contrera,

Rubino

et al. 2023

J Neurol Surg B Skull Base

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Objective The aim of this study was to investigate the safety of induction chemotherapy (IC) for patients with sinonasal malignancies with brain invasion or a neurological deficit. Methods We conducted a retrospective analysis of patients who underwent IC for sinonasal malignancies with intracranial invasion or a neurological deficit at a single tertiary cancer center from 1992 to 2020. Results In total, 460 patients with sinonasal malignancies were included in the study. Of the patients reviewed, 341 underwent IC and within this group 40 had brain invasion (BI) and 31 had a neurological deficit (ND) at presentation. The most prevalent malignancy was sinonasal undifferentiated carcinoma (BI 40%, ND 41.9%), followed by esthesioneuroblastoma (BI 27.5%, ND 9.7%). All tumors were stage T4 with the majority lacking nodal metastases (BI N0: 72.5%, ND N0: 77.5%). All patients completed at least two cycles of IC. Partial or complete response to IC was seen in 80% of BI and 71% of ND patients. No patients had cessation of treatment due to neurologic decline and none required urgent surgery. Five patients (12.5%) with BI and 2 (6.5%) with ND had interruption of IC for reasons other than neurological decline. In patients with ND, IC led to improvement of 54.5% NDs. Conclusion In patients with sinonasal malignancies with BI or ND who underwent IC, no patients had cessation of treatment due to neurologic decline. In contrast, most patients had improvement of neurologic symptoms with IC. IC was safely administered without interruption due to neurological decline or symptom progression.

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Neoadjuvant chemotherapy in the setting of locally advanced olfactory neuroblastoma with intracranial extension

Cited by 9 publications

References 17 publications

Exploration of the optimal treatment regimes for Esthesioneuroblastoma: a single center experience in China

Exploration of the optimal treatment regimes for Esthesioneuroblastoma: a single center experience in China

Unexpectedly Durable Palliation of Metastatic Olfactory Neuroblastoma Using Anti-Angiogenic Therapy with Bevacizumab

Induction Chemotherapy for Sinonasal Tumors in Patients Presenting with Brain Invasion and/or Neurological Deficits

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