Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review

Abstract

Introduction and objectives: Olfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/-adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature.

Methods: A retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution.

Results: 9 patients were included. Mean follow-up of 52.5 months (range 10-107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%.

Conclusion: Neoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications.

Keywords: Adjuvant radiotherapy; Endoscopic surgery; Estesioneuroblastoma; Esthesioneuroblastoma; Neoadjuvant chemotherapy; Neuroblastoma olfatorio; Olfactory neuroblastoma; Quimioterapia neoadyuvante; Radioterapia adyuvante; Resección endoscópica.