Treatment and Results of Olfactory Neuroblastoma

Wu, Hong Gyun; Kim, Il Han

Abstract

PURPOSE: Rarity of olfactory neuroblastoma makes it difficult for treating physician to practice with a consistent protocol. This study is performed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures.
MATERIALS AND METHODS
Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from 13 to 77 years with median of 24 years. Fifteen of 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery + postoperative radiation therapy + adjuvant chemotherapy for 2 patients, surgery + postoperative radiation therapy for 6, neoadjuvant chemotherapy + surgery for 1, surgery + adjuvant chemotherapy for 1, surgery only for 2, neoadjuvant chemotherapy + radiation therapy for 3, radiation therapy + adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient.
RESULTS
Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only.
CONCLUSIONS
Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of olfactory neuroblastoma.