Materiały źródłowe

• #1 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory neuroepithelium. ENB constitutes only 3% of all malignant intranasal neoplasm. Most of these patients presents in locally advanced stages and require multimodality treatment in form of surgery, chemotherapy and radiotherapy. Multimodality approach with a risk-adapted strategy is required to achieve good control rates while minimizing treatment related toxicity. […] The various treatment modalities used in the management of ENB are surgery, chemotherapy, radiation therapy (RT) and palliative care. Nowadays, the multimodal approach is recommended for improved survival and quality of life of the patients. […] The mainstay of the treatment is surgery. The advantage of surgery is tumor removal, immediate improvement in compressive symptoms, proper tissue for histopathological and prognostic evaluation.

• #2 Esthesioneuroblastoma: Multimodal management and review of literature

  https://www.wjgnet.com/2307-8960/full/v3/i9/774.htm

  Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory neuroepithelium. ENB constitutes only 3% of all malignant intranasal neoplasm. […] Most of these patients presents in locally advanced stages and require multimodality treatment in form of surgery, chemotherapy and radiotherapy. Multimodality approach with a risk-adapted strategy is required to achieve good control rates while minimizing treatment related toxicity. […] The various treatment modalities used in the management of ENB are surgery, chemotherapy, radiation therapy (RT) and palliative care. Nowadays, the multimodal approach is recommended for improved survival and quality of life of the patients. […] The mainstay of the treatment is surgery. The advantage of surgery is tumor removal, immediate improvement in compressive symptoms, proper tissue for histopathological and prognostic evaluation.

• #3 Childhood Esthesioneuroblastoma (PDQ®): Treatment – Patient Information [NCI] | The Children’s Hospital at Montefiore

  https://www.cham.org/health-library/article?id=ncicdr0000789047

  Childhood esthesioneuroblastoma is a rare type of cancer that forms in the olfactory nerve endings in the upper part of the nasal cavity. […] Esthesioneuroblastoma affects adults and children. Even though it is very rare, esthesioneuroblastoma is the most common nasal cavity cancer in children and teens. […] If your child is diagnosed with esthesioneuroblastoma, they will be referred to a pediatric oncologist. This is a doctor who specializes in staging and treating esthesioneuroblastoma and other cancers. They will recommend tests to determine the extent (stage) of cancer. […] Most children with esthesioneuroblastoma are at an advanced stage at the time of diagnosis. Esthesioneuroblastoma spreads most often to nearby tissue, including the olfactory bulb, nasal sinuses, or brain. It can also spread to the lymph nodes, lungs, liver, bone or bone marrow.

• #4 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Due to the location of the tumor and its proximity to the cranial cavity, esthesioneuroblastoma can be highly invasive and challenging to treat. There is no consensus on an appropriate treatment approach of esthesioneuroblastoma because of the rarity of the disease. Most studies reported cranial surgical resection with radiotherapy or chemotherapy to target the tumor. […] The preferred treatment for esthesioneuroblastoma is surgery followed by radiotherapy to prevent recurrence of the tumor. […] Several surgical approaches have been described, but post-excision recurrence rates have remained relatively high. Studies suggest better results with a bilateral approach. For cases with cribriform plate involvement, tumors are resected bilaterally using a transfacial and craniotomy approach. In a research study, the craniofacial approach decreased recurrence of esthesioneuroblastoma by 20%. Craniofacial resection can help preserve the optic nerves and brain while removing the cribriform plate, olfactory bulb, dura surrounding the bulb and even the orbital periosteum.

• #5 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory neuroepithelium. ENB constitutes only 3% of all malignant intranasal neoplasm. Most of these patients presents in locally advanced stages and require multimodality treatment in form of surgery, chemotherapy and radiotherapy. Multimodality approach with a risk-adapted strategy is required to achieve good control rates while minimizing treatment related toxicity. […] The various treatment modalities used in the management of ENB are surgery, chemotherapy, radiation therapy (RT) and palliative care. Nowadays, the multimodal approach is recommended for improved survival and quality of life of the patients. […] The mainstay of the treatment is surgery. The advantage of surgery is tumor removal, immediate improvement in compressive symptoms, proper tissue for histopathological and prognostic evaluation.

• #6 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Due to the rarity and complexity of esthesioneuroblastoma (ENB), there exists considerable heterogeneity in treatment. Complete surgical resection of the tumor followed by radiation therapy is recognized by most studies as the optimal treatment. […] However, some institutions report success with alternative treatment sequences, including surgery without radiation. More recently, chemotherapy has been introduced in the therapeutic armamentarium. Because of the lack of any randomized trial comparing these treatment protocols, the available data are summarized below. […] The literature gives little support to single-modality treatments; few studies advocate either surgery or radiation alone. A meta-analysis by Dulguerov et al clearly showed lower recurrence rates for the combination of surgery and radiotherapy. […] Some institutions advocate surgery alone for Kadish stage A tumors, whereas most suggest adjuvant radiotherapy for these lesions. A review by Carey et al found no difference in survival between surgery and surgery followed by radiation in patients with Kadish stages A and B tumors. […] A few studies advocate neoadjuvant chemotherapy for Kadish C lesions.

• #7 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory neuroepithelium. ENB constitutes only 3% of all malignant intranasal neoplasm. Most of these patients presents in locally advanced stages and require multimodality treatment in form of surgery, chemotherapy and radiotherapy. Multimodality approach with a risk-adapted strategy is required to achieve good control rates while minimizing treatment related toxicity. […] The various treatment modalities used in the management of ENB are surgery, chemotherapy, radiation therapy (RT) and palliative care. Nowadays, the multimodal approach is recommended for improved survival and quality of life of the patients. […] The mainstay of the treatment is surgery. The advantage of surgery is tumor removal, immediate improvement in compressive symptoms, proper tissue for histopathological and prognostic evaluation.

• #8 Esthesioneuroblastoma: Multimodal management and review of literature

  https://www.wjgnet.com/2307-8960/full/v3/i9/774.htm

  Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory neuroepithelium. ENB constitutes only 3% of all malignant intranasal neoplasm. […] Most of these patients presents in locally advanced stages and require multimodality treatment in form of surgery, chemotherapy and radiotherapy. Multimodality approach with a risk-adapted strategy is required to achieve good control rates while minimizing treatment related toxicity. […] The various treatment modalities used in the management of ENB are surgery, chemotherapy, radiation therapy (RT) and palliative care. Nowadays, the multimodal approach is recommended for improved survival and quality of life of the patients. […] The mainstay of the treatment is surgery. The advantage of surgery is tumor removal, immediate improvement in compressive symptoms, proper tissue for histopathological and prognostic evaluation.

• #9 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #10 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.childhood-esthesioneuroblastoma-treatment-pdq%C2%AE-treatment-health-professional-information-nci.ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. Neuromeningeal progression is the most common type of treatment failure. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites.

• #11 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #12 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory neuroepithelium. ENB constitutes only 3% of all malignant intranasal neoplasm. Most of these patients presents in locally advanced stages and require multimodality treatment in form of surgery, chemotherapy and radiotherapy. Multimodality approach with a risk-adapted strategy is required to achieve good control rates while minimizing treatment related toxicity. […] The various treatment modalities used in the management of ENB are surgery, chemotherapy, radiation therapy (RT) and palliative care. Nowadays, the multimodal approach is recommended for improved survival and quality of life of the patients. […] The mainstay of the treatment is surgery. The advantage of surgery is tumor removal, immediate improvement in compressive symptoms, proper tissue for histopathological and prognostic evaluation.

• #13 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Due to the rarity and complexity of esthesioneuroblastoma (ENB), there exists considerable heterogeneity in treatment. Complete surgical resection of the tumor followed by radiation therapy is recognized by most studies as the optimal treatment. […] However, some institutions report success with alternative treatment sequences, including surgery without radiation. More recently, chemotherapy has been introduced in the therapeutic armamentarium. Because of the lack of any randomized trial comparing these treatment protocols, the available data are summarized below. […] The literature gives little support to single-modality treatments; few studies advocate either surgery or radiation alone. A meta-analysis by Dulguerov et al clearly showed lower recurrence rates for the combination of surgery and radiotherapy. […] Some institutions advocate surgery alone for Kadish stage A tumors, whereas most suggest adjuvant radiotherapy for these lesions. A review by Carey et al found no difference in survival between surgery and surgery followed by radiation in patients with Kadish stages A and B tumors. […] A few studies advocate neoadjuvant chemotherapy for Kadish C lesions.

• #14 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Due to locally infiltrative nature of the disease, surgically clear margins are difficult to achieve. Thus there is a role of adjuvant RT to minimize the risk of local recurrence. […] The role of chemotherapy is not very clear in adjuvant settings in early tumors, but in locally advanced and metastatic tumors it has a definitive role. […] Kadish A staged tumors requires all the three modalities. Neoadjuvant approach (CT/RT/concurrent CT-RT) is preferred. […] Systemic chemotherapy and palliative RT to local site and metastatic sites are advised. Palliative care should be incorporated for improving the quality of life. […] Local recurrence and/or distant metastases remain the main problem in the management of ENB. […] The most important prognostic factors influencing the outcome reported in ENB are Hyams grade, positive lymph nodes, Kadish stage, extent of resection and postoperative RT with atleast 54 Gy. […] Most of the patients of ENB present in locally advanced stage and the optimal management depends on the cooperation between clinicians, surgeons, radiologists and pathologists from establishing diagnosis to organizing the therapeutic strategy.

• #15 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Due to locally infiltrative nature of the disease, surgically clear margins are difficult to achieve. Thus there is a role of adjuvant RT to minimize the risk of local recurrence. […] The role of chemotherapy is not very clear in adjuvant settings in early tumors, but in locally advanced and metastatic tumors it has a definitive role. […] Kadish A staged tumors requires all the three modalities. Neoadjuvant approach (CT/RT/concurrent CT-RT) is preferred. […] Systemic chemotherapy and palliative RT to local site and metastatic sites are advised. Palliative care should be incorporated for improving the quality of life. […] Local recurrence and/or distant metastases remain the main problem in the management of ENB. […] The most important prognostic factors influencing the outcome reported in ENB are Hyams grade, positive lymph nodes, Kadish stage, extent of resection and postoperative RT with atleast 54 Gy. […] Most of the patients of ENB present in locally advanced stage and the optimal management depends on the cooperation between clinicians, surgeons, radiologists and pathologists from establishing diagnosis to organizing the therapeutic strategy.

• #16 Esthesioneuroblastoma: Multimodal management and review of literature

  https://www.wjgnet.com/2307-8960/full/v3/i9/774.htm

  Adjuvant RT is indicated for Kadish stage B and C, whereas Kadish A disease can be managed with surgery alone. […] The role of chemotherapy is not very clear in adjuvant settings in early tumors, but in locally advanced and metastatic tumors it has a definitive role. […] Kadish C staged tumors requires all the three modalities. Neoadjuvant approach (CT/RT/concurrent CT-RT) is preferred. […] Systemic chemotherapy and palliative RT to local site and metastatic sites are advised. Palliative care should be incorporated for improving the quality of life. […] Most of the patients of ENB present in locally advanced stage and the optimal management depends on the cooperation between clinicians, surgeons, radiologists and pathologists from establishing diagnosis to organizing the therapeutic strategy.

• #17 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #18 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.childhood-esthesioneuroblastoma-treatment-pdq%C2%AE-treatment-health-professional-information-nci.ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. Neuromeningeal progression is the most common type of treatment failure. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites.

• #19 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #20 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Boris Bentsianov, MD

  https://www.brooklynentdoc.com/patient-education/health-library?DOCHWID=ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection. […] Reports have indicated promising results with the increased use of resection and neoadjuvant or adjuvant chemotherapy in patients with advanced-stage disease. […] Chemotherapy regimens that have been used with efficacy include the following: Cisplatin and etoposide with or without ifosfamide.

• #21 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Due to the rarity and complexity of esthesioneuroblastoma (ENB), there exists considerable heterogeneity in treatment. Complete surgical resection of the tumor followed by radiation therapy is recognized by most studies as the optimal treatment. […] However, some institutions report success with alternative treatment sequences, including surgery without radiation. More recently, chemotherapy has been introduced in the therapeutic armamentarium. Because of the lack of any randomized trial comparing these treatment protocols, the available data are summarized below. […] The literature gives little support to single-modality treatments; few studies advocate either surgery or radiation alone. A meta-analysis by Dulguerov et al clearly showed lower recurrence rates for the combination of surgery and radiotherapy. […] Some institutions advocate surgery alone for Kadish stage A tumors, whereas most suggest adjuvant radiotherapy for these lesions. A review by Carey et al found no difference in survival between surgery and surgery followed by radiation in patients with Kadish stages A and B tumors. […] A few studies advocate neoadjuvant chemotherapy for Kadish C lesions.

• #22 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #23 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/childhood-esthesioneuroblastoma-treatment-ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. […] Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. […] Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. […] Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #24 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #25 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/childhood-esthesioneuroblastoma-treatment-ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. […] Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. […] Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. […] Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #26 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Due to the rarity and complexity of esthesioneuroblastoma (ENB), there exists considerable heterogeneity in treatment. Complete surgical resection of the tumor followed by radiation therapy is recognized by most studies as the optimal treatment. […] However, some institutions report success with alternative treatment sequences, including surgery without radiation. More recently, chemotherapy has been introduced in the therapeutic armamentarium. Because of the lack of any randomized trial comparing these treatment protocols, the available data are summarized below. […] The literature gives little support to single-modality treatments; few studies advocate either surgery or radiation alone. A meta-analysis by Dulguerov et al clearly showed lower recurrence rates for the combination of surgery and radiotherapy. […] Some institutions advocate surgery alone for Kadish stage A tumors, whereas most suggest adjuvant radiotherapy for these lesions. A review by Carey et al found no difference in survival between surgery and surgery followed by radiation in patients with Kadish stages A and B tumors. […] A few studies advocate neoadjuvant chemotherapy for Kadish C lesions.

• #27 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #28 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/childhood-esthesioneuroblastoma-treatment-ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. […] Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. […] Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. […] Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #29 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #30 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #31 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #32 Esthesioneuroblastoma (Olfactory Neuroblastoma) * Phoenix Scottsdale Arizona ENT Sinus Surgeons

  http://www.arizonasinus.com/condition-esthesioneuroblastoma.htm

  Surgery combined with radiation therapy (and in some cases, chemotherapy) is the standard of care for esthesioneuroblastoma. Patients with this malignant tumor are best served by having an evaluation with an otolaryngologist (ENT physician), neurosurgeon, radiation oncologist and possibly medical oncologist. […] There are two main approaches for surgical removal of esthesioneuroblastoma. One approach, craniofacial resection involves incisions on the scalp and/or face to approach the tumor and expose the adjacent brain through the outside of the skull. The second approach, endoscopic trans-nasal resection, involves using endoscopes and specialized instruments to work through the nasal passages to remove the tumor from underneath the brain, inside the skull. Most studies report similar cancer control rates with both surgical approaches.

• #33 Esthesioneuroblastoma

  https://med.uth.edu/orl/texas-sinus-institute/patient-education/esthesioneuroblastoma/

  Although early reports on chemotherapy in ENB focused on patients with recurrent or metastatic disease, adjuvant chemotherapy is now commonly employed for patients with advanced local and regional disease. […] Treatment for ENB changed dramatically with the introduction of the combined transcranial and transfacial approach for tumors of the paranasal sinuses involving the anterior skull base. […] The traditional surgical approach for ENB, favored by many institutions and authors, is craniofacial resection (CFR). This is a combined transcranial and transfacial approach, typically including a frontal craniotomy, and lateral rhinotomy or midfacial degloving. The objective is to achieve an en bloc resection of tumor and involved structures. […] While traditional craniofacial resection remains the gold standard, less invasive endoscopic techniques have become increasingly utilized. At Texas Sinus Institute we provide expertise in minimally-invasive endoscopic management of all skull base tumors, including ENB. Minimally invasive endoscopic resection (MIER) is a complete endoscopic approach, typically suited for tumors that have not invaded the brain tissue.

• #34 Esthesioneuroblastoma

  https://med.uth.edu/orl/texas-sinus-institute/patient-education/esthesioneuroblastoma/

  Although early reports on chemotherapy in ENB focused on patients with recurrent or metastatic disease, adjuvant chemotherapy is now commonly employed for patients with advanced local and regional disease. […] Treatment for ENB changed dramatically with the introduction of the combined transcranial and transfacial approach for tumors of the paranasal sinuses involving the anterior skull base. […] The traditional surgical approach for ENB, favored by many institutions and authors, is craniofacial resection (CFR). This is a combined transcranial and transfacial approach, typically including a frontal craniotomy, and lateral rhinotomy or midfacial degloving. The objective is to achieve an en bloc resection of tumor and involved structures. […] While traditional craniofacial resection remains the gold standard, less invasive endoscopic techniques have become increasingly utilized. At Texas Sinus Institute we provide expertise in minimally-invasive endoscopic management of all skull base tumors, including ENB. Minimally invasive endoscopic resection (MIER) is a complete endoscopic approach, typically suited for tumors that have not invaded the brain tissue.

• #35 Esthesioneuroblastoma | UVA Health

  https://uvahealth.com/services/head-neck-cancer/esthesioneuroblastoma

  Esthesioneuroblastoma is also known as an olfactory neuroblastoma (or ONB). It’s a cancerous tumor of the small nerve cells along the roof the nose. These nerve cells provide our sense of smell. […] At UVA Health, you’ll find a team of experts to tailor treatment for esthesioneuroblastoma. […] Surgery is usually needed for a long-term cure. A team approach is often used, with head and neck surgeons working directly with neurosurgeons to remove all portions of the tumor. […] At UVA Health, we use the craniofacial approach. This treatment includes making incisions on the face (next to the nose) to remove the portion of the tumor from the nose, as well as incisions along the top of the head that allow neurosurgeons to remove portions of the tumor from the brain. […] This treatment is often used in combination with radiation and chemotherapy. […] Radiation therapy alone is used in some cases, but it usually isn’t as successful without surgery. At UVA Health, radiation is often used before surgery to shrink the tumor. […] We also use chemotherapy to treat esthesioneuroblastoma in patients with the most extensive disease.

• #36 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Endoscopic craniofacial resection (ECFR) has become a widely accepted treatment modality. Multiple studies have shown it to be a safe, feasible, and oncologically sound technique. […] The benefits of an endoscopic approach include decreased time in surgery, blood loss, morbidity, postoperative complications, and cost. However, excess bleeding can hinder the endoscopic approach. Endoscopic resection followed by gamma-knife stereotactic radiosurgery has demonstrated positive outcomes. […] Neck metastasis is present at presentation in 57% of patients. When neck disease is diagnosed at the initial presentation, it should be treated surgically. […] A literature review by Beitler et al found an incidence of delayed neck metastasis of 19%, but half of these patients also presented with local recurrence. […] Salvage treatment was successful in 70% of these patients.

• #37 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Endoscopic craniofacial resection (ECFR) has become a widely accepted treatment modality. Multiple studies have shown it to be a safe, feasible, and oncologically sound technique. […] The benefits of an endoscopic approach include decreased time in surgery, blood loss, morbidity, postoperative complications, and cost. However, excess bleeding can hinder the endoscopic approach. Endoscopic resection followed by gamma-knife stereotactic radiosurgery has demonstrated positive outcomes. […] Neck metastasis is present at presentation in 57% of patients. When neck disease is diagnosed at the initial presentation, it should be treated surgically. […] A literature review by Beitler et al found an incidence of delayed neck metastasis of 19%, but half of these patients also presented with local recurrence. […] Salvage treatment was successful in 70% of these patients.

• #38 Esthesioneuroblastoma

  https://med.uth.edu/orl/texas-sinus-institute/patient-education/esthesioneuroblastoma/

  Although early reports on chemotherapy in ENB focused on patients with recurrent or metastatic disease, adjuvant chemotherapy is now commonly employed for patients with advanced local and regional disease. […] Treatment for ENB changed dramatically with the introduction of the combined transcranial and transfacial approach for tumors of the paranasal sinuses involving the anterior skull base. […] The traditional surgical approach for ENB, favored by many institutions and authors, is craniofacial resection (CFR). This is a combined transcranial and transfacial approach, typically including a frontal craniotomy, and lateral rhinotomy or midfacial degloving. The objective is to achieve an en bloc resection of tumor and involved structures. […] While traditional craniofacial resection remains the gold standard, less invasive endoscopic techniques have become increasingly utilized. At Texas Sinus Institute we provide expertise in minimally-invasive endoscopic management of all skull base tumors, including ENB. Minimally invasive endoscopic resection (MIER) is a complete endoscopic approach, typically suited for tumors that have not invaded the brain tissue.

• #39 Esthesioneuroblastoma

  https://med.uth.edu/orl/texas-sinus-institute/patient-education/esthesioneuroblastoma/

  Endoscopic techniques have now been shown to have comparable success rates but fewer complications compared with traditional CFR. […] At TSBI, Computer-Aided Surgery (CAS), also known as Image-Guided Surgery (IGS), is routinely employed in all tumor resections. The availability of advanced CT/MRI fusion and 3-D reconstruction protocols enhances the safety and outcome of our interventions.

• #40 Endoscopic treatment of esthesioneuroblastoma | Brazilian Journal of Otorhinolaryngology

  https://www.bjorl.org/en-endoscopic-treatment-esthesioneuroblastoma-articulo-S1808869415308065

  Management of this tumor is uncertain because of the paucity of cases and advances in diagnostic and treatment methods. Current approaches include en bloc surgery, single or combined endoscopic procedures, radiotherapy, and chemotherapy. […] Endoscopic resection of the primary tumor with equivalent margins to those of open surgery was possible in all patients. […] All patients were treated with postoperative supplementary external radiotherapy, which was started in the third to fourth week after surgery. […] The postoperative morbidity related to endoscopy was minor. […] Esthesioneuroblastoma is a potentially curable malignancy with surgery and radiotherapy. Endoscopic techniques result in significant esthetic and functional gains, reduced recovery times, lower costs, and less morbidity and mortality compared to the conventional approach.

• #41 Endoscopic treatment of esthesioneuroblastoma | Brazilian Journal of Otorhinolaryngology

  https://www.elsevier.es/en-revista-brazilian-journal-otorhinolaryngology-english-edition–497-articulo-endoscopic-treatment-esthesioneuroblastoma-S1808869415308065

  Esthesioneuroblastoma is an uncommon malignant tumor of the nasal vault. Treatment consists of craniofacial resection. As endoscopic techniques have advanced, this approach has been recommended to avoid morbidity and to reduce costs. […] The same surgical team – experienced in craniofacial resection and nasosinusal endoscopy – carried out the procedures. Endoscopic resection of the primary tumor with equivalent margins to those of open surgery was possible in all patients. […] After debulking, although nasosinusal tumors could appear large, the infiltrative portion was proportionally smaller and generally limited to the lateral or superior walls of the ethmoid. […] The hospital stay was from 2 to 5 days. All patients were treated with postoperative supplementary external radiotherapy, which was started in the third to fourth week after surgery. […] Esthesioneuroblastoma is a potentially curable malignancy with surgery and radiotherapy. Endoscopic techniques result in significant esthetic and functional gains, reduced recovery times, lower costs, and less morbidity and mortality compared to the conventional approach.

• #42 Endoscopic treatment of esthesioneuroblastoma | Brazilian Journal of Otorhinolaryngology

  https://www.bjorl.org/en-endoscopic-treatment-esthesioneuroblastoma-articulo-S1808869415308065

  Management of this tumor is uncertain because of the paucity of cases and advances in diagnostic and treatment methods. Current approaches include en bloc surgery, single or combined endoscopic procedures, radiotherapy, and chemotherapy. […] Endoscopic resection of the primary tumor with equivalent margins to those of open surgery was possible in all patients. […] All patients were treated with postoperative supplementary external radiotherapy, which was started in the third to fourth week after surgery. […] The postoperative morbidity related to endoscopy was minor. […] Esthesioneuroblastoma is a potentially curable malignancy with surgery and radiotherapy. Endoscopic techniques result in significant esthetic and functional gains, reduced recovery times, lower costs, and less morbidity and mortality compared to the conventional approach.

• #43 Endoscopic treatment of esthesioneuroblastoma | Brazilian Journal of Otorhinolaryngology

  https://www.bjorl.org/en-endoscopic-treatment-esthesioneuroblastoma-articulo-S1808869415308065

  Management of this tumor is uncertain because of the paucity of cases and advances in diagnostic and treatment methods. Current approaches include en bloc surgery, single or combined endoscopic procedures, radiotherapy, and chemotherapy. […] Endoscopic resection of the primary tumor with equivalent margins to those of open surgery was possible in all patients. […] All patients were treated with postoperative supplementary external radiotherapy, which was started in the third to fourth week after surgery. […] The postoperative morbidity related to endoscopy was minor. […] Esthesioneuroblastoma is a potentially curable malignancy with surgery and radiotherapy. Endoscopic techniques result in significant esthetic and functional gains, reduced recovery times, lower costs, and less morbidity and mortality compared to the conventional approach.

• #44 Olfactory Neuroblastoma (Esthesioneuroblastoma) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/olfactory-neuroblastoma.html

  Olfactory neuroblastoma (esthesioneuroblastoma) is a very rare cancer that develops in the upper nasal cavity near the brain. […] Stanford is a global referral center for the diagnosis and surgical treatment of olfactory neuroblastoma, using the endoscopic endonasal approach to surgery. […] The primary treatment for olfactory neuroblastomas is endoscopic endonasal surgery, which is a scarless surgery that accesses the tumor through the nostril. […] When the tumor is large, your surgeon may combine endoscopic endonasal surgery with craniotomy to remove the tumor. […] Radiation therapy may be recommended after surgery if the tumor is thought to be aggressive, if it was impossible to fully remove, or if it recurs. […] If the tumor has spread to the brain, eye socket, or lymph nodes or if it recurs — a course of chemotherapy may be recommended. […] Our team of neurosurgeons, head and neck surgeons, radiation oncologists and other specialists work together to develop an individualized treatment plan for your needs. Most people with olfactory neuroblastoma are cured with treatment.

• #45 Olfactory Neuroblastoma (Esthesioneuroblastoma) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/ear-nose-and-throat/olfactory-neuroblastoma.html

  Olfactory neuroblastoma (esthesioneuroblastoma) is a very rare cancer that develops in the upper nasal cavity near the brain. […] Stanford is a global referral center for the diagnosis and surgical treatment of olfactory neuroblastoma, using the endoscopic endonasal approach to surgery. […] The primary treatment for olfactory neuroblastomas is endoscopic endonasal surgery, which is a scarless surgery that accesses the tumor through the nostril. […] When the tumor is large, your surgeon may combine endoscopic endonasal surgery with craniotomy to remove the tumor. […] Radiation therapy may be recommended after surgery if the tumor is thought to be aggressive, if it was impossible to fully remove, or if it recurs. […] If the tumor has spread to the brain, eye socket, or lymph nodes or if it recurs — a course of chemotherapy may be recommended. […] Our team of neurosurgeons, head and neck surgeons, radiation oncologists and other specialists work together to develop an individualized treatment plan for your needs. Most people with olfactory neuroblastoma are cured with treatment.

• #46 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Endoscopic craniofacial resection (ECFR) has become a widely accepted treatment modality. Multiple studies have shown it to be a safe, feasible, and oncologically sound technique. […] The benefits of an endoscopic approach include decreased time in surgery, blood loss, morbidity, postoperative complications, and cost. However, excess bleeding can hinder the endoscopic approach. Endoscopic resection followed by gamma-knife stereotactic radiosurgery has demonstrated positive outcomes. […] Neck metastasis is present at presentation in 57% of patients. When neck disease is diagnosed at the initial presentation, it should be treated surgically. […] A literature review by Beitler et al found an incidence of delayed neck metastasis of 19%, but half of these patients also presented with local recurrence. […] Salvage treatment was successful in 70% of these patients.

• #47 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Endoscopic craniofacial resection (ECFR) has become a widely accepted treatment modality. Multiple studies have shown it to be a safe, feasible, and oncologically sound technique. […] The benefits of an endoscopic approach include decreased time in surgery, blood loss, morbidity, postoperative complications, and cost. However, excess bleeding can hinder the endoscopic approach. Endoscopic resection followed by gamma-knife stereotactic radiosurgery has demonstrated positive outcomes. […] Neck metastasis is present at presentation in 57% of patients. When neck disease is diagnosed at the initial presentation, it should be treated surgically. […] A literature review by Beitler et al found an incidence of delayed neck metastasis of 19%, but half of these patients also presented with local recurrence. […] Salvage treatment was successful in 70% of these patients.

• #48 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Endoscopic craniofacial resection (ECFR) has become a widely accepted treatment modality. Multiple studies have shown it to be a safe, feasible, and oncologically sound technique. […] The benefits of an endoscopic approach include decreased time in surgery, blood loss, morbidity, postoperative complications, and cost. However, excess bleeding can hinder the endoscopic approach. Endoscopic resection followed by gamma-knife stereotactic radiosurgery has demonstrated positive outcomes. […] Neck metastasis is present at presentation in 57% of patients. When neck disease is diagnosed at the initial presentation, it should be treated surgically. […] A literature review by Beitler et al found an incidence of delayed neck metastasis of 19%, but half of these patients also presented with local recurrence. […] Salvage treatment was successful in 70% of these patients.

• #49 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Most institutions favor surgery as the first treatment modality, followed by postoperative irradiation. […] Preoperative radiation results in the usual loss of definable tumor borders, which makes an en-bloc resection problematic. A theoretical advantage of preoperative radiation therapy is that it can convert an inoperable tumor to one that is amenable to resection, but that view is not widely supported. […] Standard techniques include external megavoltage beam and a 3-field technique; an anterior port is combined with wedged lateral fields to provide a homogeneous dose distribution. […] The dose varies from 5500-6500 cGy. The majority of patients receive 6000 cGy. These doses are close to or exceed the maximum radiation dose recommended for sensitive structures such as the optic nerve, optic chiasma, brainstem, retina, and lens. Therefore, those patients are susceptible to cataract formation and glaucoma.

• #50 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Most institutions favor surgery as the first treatment modality, followed by postoperative irradiation. […] Preoperative radiation results in the usual loss of definable tumor borders, which makes an en-bloc resection problematic. A theoretical advantage of preoperative radiation therapy is that it can convert an inoperable tumor to one that is amenable to resection, but that view is not widely supported. […] Standard techniques include external megavoltage beam and a 3-field technique; an anterior port is combined with wedged lateral fields to provide a homogeneous dose distribution. […] The dose varies from 5500-6500 cGy. The majority of patients receive 6000 cGy. These doses are close to or exceed the maximum radiation dose recommended for sensitive structures such as the optic nerve, optic chiasma, brainstem, retina, and lens. Therefore, those patients are susceptible to cataract formation and glaucoma.

• #51 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Most institutions favor surgery as the first treatment modality, followed by postoperative irradiation. […] Preoperative radiation results in the usual loss of definable tumor borders, which makes an en-bloc resection problematic. A theoretical advantage of preoperative radiation therapy is that it can convert an inoperable tumor to one that is amenable to resection, but that view is not widely supported. […] Standard techniques include external megavoltage beam and a 3-field technique; an anterior port is combined with wedged lateral fields to provide a homogeneous dose distribution. […] The dose varies from 5500-6500 cGy. The majority of patients receive 6000 cGy. These doses are close to or exceed the maximum radiation dose recommended for sensitive structures such as the optic nerve, optic chiasma, brainstem, retina, and lens. Therefore, those patients are susceptible to cataract formation and glaucoma.

• #52 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Most institutions favor surgery as the first treatment modality, followed by postoperative irradiation. […] Preoperative radiation results in the usual loss of definable tumor borders, which makes an en-bloc resection problematic. A theoretical advantage of preoperative radiation therapy is that it can convert an inoperable tumor to one that is amenable to resection, but that view is not widely supported. […] Standard techniques include external megavoltage beam and a 3-field technique; an anterior port is combined with wedged lateral fields to provide a homogeneous dose distribution. […] The dose varies from 5500-6500 cGy. The majority of patients receive 6000 cGy. These doses are close to or exceed the maximum radiation dose recommended for sensitive structures such as the optic nerve, optic chiasma, brainstem, retina, and lens. Therefore, those patients are susceptible to cataract formation and glaucoma.

• #53 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Most institutions favor surgery as the first treatment modality, followed by postoperative irradiation. […] Preoperative radiation results in the usual loss of definable tumor borders, which makes an en-bloc resection problematic. A theoretical advantage of preoperative radiation therapy is that it can convert an inoperable tumor to one that is amenable to resection, but that view is not widely supported. […] Standard techniques include external megavoltage beam and a 3-field technique; an anterior port is combined with wedged lateral fields to provide a homogeneous dose distribution. […] The dose varies from 5500-6500 cGy. The majority of patients receive 6000 cGy. These doses are close to or exceed the maximum radiation dose recommended for sensitive structures such as the optic nerve, optic chiasma, brainstem, retina, and lens. Therefore, those patients are susceptible to cataract formation and glaucoma.

• #54 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Most institutions favor surgery as the first treatment modality, followed by postoperative irradiation. […] Preoperative radiation results in the usual loss of definable tumor borders, which makes an en-bloc resection problematic. A theoretical advantage of preoperative radiation therapy is that it can convert an inoperable tumor to one that is amenable to resection, but that view is not widely supported. […] Standard techniques include external megavoltage beam and a 3-field technique; an anterior port is combined with wedged lateral fields to provide a homogeneous dose distribution. […] The dose varies from 5500-6500 cGy. The majority of patients receive 6000 cGy. These doses are close to or exceed the maximum radiation dose recommended for sensitive structures such as the optic nerve, optic chiasma, brainstem, retina, and lens. Therefore, those patients are susceptible to cataract formation and glaucoma.

• #55 Advanced Radiation Techniques in the Treatment of Esthesioneuroblastoma: A 7-Year Single-Institution’s Clinical Experience

  https://www.mdpi.com/2072-6694/10/11/457

  (1) Background: Esthesioneuroblastoma (ENB) is a rare tumor entity originating from the olfactory neuroepithelium. There is a scarcity of data about different treatment strategies. Intensity modulated radiotherapy (IMRT) and carbon ion radiotherapy (CIRT) are advanced radiation techniques that might improve local tumor control. […] (4) Conclusions: Our results demonstrate that IMRT, CIRT, a combined approach of IMRT and CIRT as well as reirradiation with CIRT seem to be feasible and effective treatment methods in ENB. […] The current data demonstrate different radiation techniques in the treatment of ENB. Considering the advanced tumor stage of the cohort, the results show acceptable PFS and OS rates in short-term follow-ups. IMRT, CIRT, a combined treatment of IMRT and CIRT as well as reCIRT seem to be feasible and effective approaches in ENB, that merit further evaluation.

• #56 Esthesioneuroblastoma Treatment Market – Global Market Size, Share, and Trends Analysis Report – Industry Overview and Forecast to 2032 | Data Bridge Market Research

  https://www.databridgemarketresearch.com/reports/global-esthesioneuroblastoma-treatment-market?srsltid=AfmBOoo1wxg-ey_zHSG_Ui9ZJwuhFtYIqRTUQ-A2GBxXpThcOJqepi_J

  One key trend in the esthesioneuroblastoma treatment market is the increasing adoption of advanced radiation therapy techniques, such as intensity-modulated radiation therapy (IMRT) and proton therapy. These therapies provide targeted treatment, minimizing damage to surrounding healthy tissues while effectively targeting tumor cells. For instance, IMRT has been shown to reduce the risk of complications and side effects, improving patient outcomes. This trend is driven by advancements in technology and the need for more precise treatments for rare cancers such as esthesioneuroblastoma. […] Advancements in treatment options for esthesioneuroblastoma (ENB) are significantly improving patient outcomes and creating new opportunities in the market. The development of targeted therapies and immunotherapies is revolutionizing ENB treatment by focusing on specific cancer cells, thereby increasing treatment efficacy while minimizing damage to healthy tissues. For instance, the use of checkpoint inhibitors in immunotherapy has shown promising results in managing rare cancers such as ENB. In addition, advancements in radiation therapy, such as intensity-modulated radiation therapy (IMRT), allow for highly targeted treatment with precision, reducing the potential for side effects and enhancing patient quality of life.

• #57 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Endoscopic craniofacial resection (ECFR) has become a widely accepted treatment modality. Multiple studies have shown it to be a safe, feasible, and oncologically sound technique. […] The benefits of an endoscopic approach include decreased time in surgery, blood loss, morbidity, postoperative complications, and cost. However, excess bleeding can hinder the endoscopic approach. Endoscopic resection followed by gamma-knife stereotactic radiosurgery has demonstrated positive outcomes. […] Neck metastasis is present at presentation in 57% of patients. When neck disease is diagnosed at the initial presentation, it should be treated surgically. […] A literature review by Beitler et al found an incidence of delayed neck metastasis of 19%, but half of these patients also presented with local recurrence. […] Salvage treatment was successful in 70% of these patients.

• #58 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  External Beam Radiation: This method uses high-energy beams focused on the tumor, and advanced techniques like Intensity-Modulated Radiation Therapy (IMRT) help focus the radiation on the cancer while protecting healthy tissue. […] Proton Therapy: Proton therapy delivers radiation directly to the tumor with minimal impact on surrounding tissues, making it beneficial for tumors located near vital structures. […] Chemotherapy is typically used when the cancer has spread or alongside surgery and radiation to improve their effectiveness. […] Combination with Other Treatments: Chemotherapy may shrink the tumor before surgery (neoadjuvant) or help prevent recurrence after surgery (adjuvant). Common drugs include cisplatin and etoposide. […] Clinical Trials and Targeted Therapy: Ongoing research is exploring new treatments, including therapies designed to target specific cancer pathways.

• #59 Advanced Radiation Techniques in the Treatment of Esthesioneuroblastoma: A 7-Year Single-Institution’s Clinical Experience

  https://www.mdpi.com/2072-6694/10/11/457

  (1) Background: Esthesioneuroblastoma (ENB) is a rare tumor entity originating from the olfactory neuroepithelium. There is a scarcity of data about different treatment strategies. Intensity modulated radiotherapy (IMRT) and carbon ion radiotherapy (CIRT) are advanced radiation techniques that might improve local tumor control. […] (4) Conclusions: Our results demonstrate that IMRT, CIRT, a combined approach of IMRT and CIRT as well as reirradiation with CIRT seem to be feasible and effective treatment methods in ENB. […] The current data demonstrate different radiation techniques in the treatment of ENB. Considering the advanced tumor stage of the cohort, the results show acceptable PFS and OS rates in short-term follow-ups. IMRT, CIRT, a combined treatment of IMRT and CIRT as well as reCIRT seem to be feasible and effective approaches in ENB, that merit further evaluation.

• #60 Esthesioneuroblastoma | UVA Health

  https://uvahealth.com/services/head-neck-cancer/esthesioneuroblastoma

  Esthesioneuroblastoma is also known as an olfactory neuroblastoma (or ONB). It’s a cancerous tumor of the small nerve cells along the roof the nose. These nerve cells provide our sense of smell. […] At UVA Health, you’ll find a team of experts to tailor treatment for esthesioneuroblastoma. […] Surgery is usually needed for a long-term cure. A team approach is often used, with head and neck surgeons working directly with neurosurgeons to remove all portions of the tumor. […] At UVA Health, we use the craniofacial approach. This treatment includes making incisions on the face (next to the nose) to remove the portion of the tumor from the nose, as well as incisions along the top of the head that allow neurosurgeons to remove portions of the tumor from the brain. […] This treatment is often used in combination with radiation and chemotherapy. […] Radiation therapy alone is used in some cases, but it usually isn’t as successful without surgery. At UVA Health, radiation is often used before surgery to shrink the tumor. […] We also use chemotherapy to treat esthesioneuroblastoma in patients with the most extensive disease.

• #61 Esthesioneuroblastoma

  https://med.uth.edu/orl/texas-sinus-institute/patient-education/esthesioneuroblastoma/

  The treatment of ENB requires a multi-disciplinary team including an Otorhinolaryngologist-Head Neck surgeon, a neurosurgeon, a radiation oncologist, and a medical oncologist. Other specialists, such as an ophthalmologist, may become involved as needed. […] Treatment depends on the local tumor stage and whether or not there is regional or distant metastatic disease. Surgery alone is best reserved for patients with small tumors located in the sinonasal cavity without involvement of the skull base or orbit. For more advanced tumors, the most successful treatment includes surgery and radiation therapy with most institutions favoring delivery of postoperative, rather than preoperative, radiotherapy. At TSBI, large and bulky tumors (T3 and T4) are treated with preoperative chemotherapy and radiotherapy followed by surgery. This allows for a potentially less invasive and less morbid surgical resection.

• #62 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Radiotherapy alone is reserved only for small lesions not appropriate for either surgery or chemotherapy. Both photon and proton radiotherapy have been used effectively to treat esthesioneuroblastoma. Proton radiotherapy has recently been shown to be effective in a 10-person study with Kadish C tumors, while delivering less toxicity to the nervous system. […] Chemotherapy is used in a multimodality treatment plan generally for more advanced, unresectable or reoccurring tumors. Cyclophosphamide, vincristine and doxorubicin have been used as neoadjuvant chemotherapy drugs for grade C esthesioneuroblastoma before surgical resection, producing fair outcomes. Cisplatin and etoposide are often used to treat esthesioneuroblastoma as neoadjuvants or adjuvants with radiotherapy or surgery. […] Study results are promising. In advanced stage esthesioneuroblastoma in pediatric patients, where surgery is no longer possible, aggressive chemotherapy and radiotherapy has resulted in some tumor control and long-term survival.

• #63 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Radiotherapy alone is reserved only for small lesions not appropriate for either surgery or chemotherapy. Both photon and proton radiotherapy have been used effectively to treat esthesioneuroblastoma. Proton radiotherapy has recently been shown to be effective in a 10-person study with Kadish C tumors, while delivering less toxicity to the nervous system. […] Chemotherapy is used in a multimodality treatment plan generally for more advanced, unresectable or reoccurring tumors. Cyclophosphamide, vincristine and doxorubicin have been used as neoadjuvant chemotherapy drugs for grade C esthesioneuroblastoma before surgical resection, producing fair outcomes. Cisplatin and etoposide are often used to treat esthesioneuroblastoma as neoadjuvants or adjuvants with radiotherapy or surgery. […] Study results are promising. In advanced stage esthesioneuroblastoma in pediatric patients, where surgery is no longer possible, aggressive chemotherapy and radiotherapy has resulted in some tumor control and long-term survival.

• #64 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Radiotherapy alone is reserved only for small lesions not appropriate for either surgery or chemotherapy. Both photon and proton radiotherapy have been used effectively to treat esthesioneuroblastoma. Proton radiotherapy has recently been shown to be effective in a 10-person study with Kadish C tumors, while delivering less toxicity to the nervous system. […] Chemotherapy is used in a multimodality treatment plan generally for more advanced, unresectable or reoccurring tumors. Cyclophosphamide, vincristine and doxorubicin have been used as neoadjuvant chemotherapy drugs for grade C esthesioneuroblastoma before surgical resection, producing fair outcomes. Cisplatin and etoposide are often used to treat esthesioneuroblastoma as neoadjuvants or adjuvants with radiotherapy or surgery. […] Study results are promising. In advanced stage esthesioneuroblastoma in pediatric patients, where surgery is no longer possible, aggressive chemotherapy and radiotherapy has resulted in some tumor control and long-term survival.

• #65 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #66 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #67 Esthesioneuroblastoma Treatment & Management: Approach Considerations, Surgical Care, Consultations

  https://emedicine.medscape.com/article/278047-treatment

  Chemotherapy is not recommended for routine treatment of ENB. Exceptions include palliative treatments or as part of a multimodality treatment in patients with advanced or metastatic disease. […] The use of chemotherapy has been advocated by authors from the University of Virginia. […] In their protocol, patients with advanced disease (eg, Kadish stage C) are treated first with two cycles of cyclophosphamide (300-650 mg/m2) and vincristine (1-2 mg) with or without doxorubicin, followed by 50 Gy of radiotherapy, which then is followed by a craniofacial resection. With this regimen, the 5-year and 10-year actuarial survival rates are 72% and 60%, respectively. Similar results have been obtained without chemotherapy, and how much chemotherapy contributed to the cure rates is unclear. […] Surgery remains the primary treatment for esthesioneuroblastoma (ENB) and offers the best chance for locoregional control as well as survival. Both open and endoscopic craniofacial resection have achieved complete surgical resection with tumor-free margins. […] In the recent decades, craniofacial resection followed by radiation therapy has been repeatedly referred to as the gold standard for treatment, and thus, other treatment modalities should be measured against it.

• #68 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  Reports have indicated promising results with the increased use of resection and neoadjuvant or adjuvant chemotherapy in patients with advanced-stage disease. Chemotherapy regimens that have been used with efficacy include the following: Cisplatin and etoposide with or without ifosfamide. Vincristine, dactinomycin, and cyclophosphamide with or without doxorubicin. Ifosfamide and etoposide. Cisplatin plus etoposide or doxorubicin. Vincristine, doxorubicin, and cyclophosphamide. Irinotecan plus docetaxel.

• #69 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/childhood-esthesioneuroblastoma-treatment-ncicdr0000790381

  Other techniques such as stereotactic radiosurgery and proton-beam therapy (charged-particle radiation therapy) may also play a role in the management of this tumor. […] Reports have indicated promising results with the increased use of resection and neoadjuvant or adjuvant chemotherapy in patients with advanced-stage disease. […] Chemotherapy regimens that have been used with efficacy include the following: Cisplatin and etoposide with or without ifosfamide. […] Vincristine, dactinomycin, and cyclophosphamide with or without doxorubicin. […] Ifosfamide and etoposide. […] Cisplatin plus etoposide or doxorubicin. […] Vincristine, doxorubicin, and cyclophosphamide. […] Irinotecan plus docetaxel.

• #70 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Radiotherapy alone is reserved only for small lesions not appropriate for either surgery or chemotherapy. Both photon and proton radiotherapy have been used effectively to treat esthesioneuroblastoma. Proton radiotherapy has recently been shown to be effective in a 10-person study with Kadish C tumors, while delivering less toxicity to the nervous system. […] Chemotherapy is used in a multimodality treatment plan generally for more advanced, unresectable or reoccurring tumors. Cyclophosphamide, vincristine and doxorubicin have been used as neoadjuvant chemotherapy drugs for grade C esthesioneuroblastoma before surgical resection, producing fair outcomes. Cisplatin and etoposide are often used to treat esthesioneuroblastoma as neoadjuvants or adjuvants with radiotherapy or surgery. […] Study results are promising. In advanced stage esthesioneuroblastoma in pediatric patients, where surgery is no longer possible, aggressive chemotherapy and radiotherapy has resulted in some tumor control and long-term survival.

• #71 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Radiotherapy alone is reserved only for small lesions not appropriate for either surgery or chemotherapy. Both photon and proton radiotherapy have been used effectively to treat esthesioneuroblastoma. Proton radiotherapy has recently been shown to be effective in a 10-person study with Kadish C tumors, while delivering less toxicity to the nervous system. […] Chemotherapy is used in a multimodality treatment plan generally for more advanced, unresectable or reoccurring tumors. Cyclophosphamide, vincristine and doxorubicin have been used as neoadjuvant chemotherapy drugs for grade C esthesioneuroblastoma before surgical resection, producing fair outcomes. Cisplatin and etoposide are often used to treat esthesioneuroblastoma as neoadjuvants or adjuvants with radiotherapy or surgery. […] Study results are promising. In advanced stage esthesioneuroblastoma in pediatric patients, where surgery is no longer possible, aggressive chemotherapy and radiotherapy has resulted in some tumor control and long-term survival.

• #72 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #73 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/childhood-esthesioneuroblastoma-treatment-ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. […] Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. […] Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. […] Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #74 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #75 Childhood Esthesioneuroblastoma Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/childhood-esthesioneuroblastoma-treatment-ncicdr0000790381

  The use of multimodal therapy optimizes the chances for survival, with more than 70% of children expected to survive 5 or more years after initial diagnosis. […] Treatment options according to Kadish stage include the following: Kadish stage A: Surgery alone with clear margins. Adjuvant radiation therapy is indicated in patients with close and positive margins or with residual disease. […] Kadish stage B: Surgery followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is controversial. […] Kadish stage C: Neoadjuvant approach with chemotherapy, radiation therapy, or concurrent chemoradiation therapy followed by surgery. […] Kadish stage D: Systemic chemotherapy and radiation therapy to local and metastatic sites. […] The mainstay of treatment is surgery and radiation therapy. However, esthesioneuroblastoma is a chemosensitive neoplasm, and the use of neoadjuvant chemotherapy can facilitate resection.

• #76 Esthesioneuroblastoma (Olfactory Neuroblastoma) – MD Searchlight

  https://mdsearchlight.com/cancer/esthesioneuroblastoma-olfactory-neuroblastoma/

  For patients where the disease has spread to distant parts of the body, relieving symptoms and improving quality of life, or palliative therapy, might be the best option. If the cancer can’t be removed surgically because it’s spread too much, chemoradiation (a mix of chemotherapy and radiation treatment) can sometimes be used to make surgery possible in previously inoperable cases.

• #77 Esthesioneuroblastoma – Wikipedia

  https://en.wikipedia.org/wiki/Esthesioneuroblastoma

  Radiotherapy alone is reserved only for small lesions not appropriate for either surgery or chemotherapy. Both photon and proton radiotherapy have been used effectively to treat esthesioneuroblastoma. Proton radiotherapy has recently been shown to be effective in a 10-person study with Kadish C tumors, while delivering less toxicity to the nervous system. […] Chemotherapy is used in a multimodality treatment plan generally for more advanced, unresectable or reoccurring tumors. Cyclophosphamide, vincristine and doxorubicin have been used as neoadjuvant chemotherapy drugs for grade C esthesioneuroblastoma before surgical resection, producing fair outcomes. Cisplatin and etoposide are often used to treat esthesioneuroblastoma as neoadjuvants or adjuvants with radiotherapy or surgery. […] Study results are promising. In advanced stage esthesioneuroblastoma in pediatric patients, where surgery is no longer possible, aggressive chemotherapy and radiotherapy has resulted in some tumor control and long-term survival.

• #78 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  Emerging Treatments: Targeted therapy and immunotherapy are being studied in clinical trials, offering hope for patients with recurrent or treatment-resistant tumors. These therapies aim to be more precise and cause fewer side effects than traditional methods. […] Managing the side effects of treatment and ensuring quality of life is essential in one’s recovery journey. […] Pain, nausea, and fatigue can be addressed with medications and supportive therapies. Post-surgical rehabilitation may be needed to help regain functions such as speech or motor skills, particularly if the surgery impacts critical areas. […] Counseling and support groups are available to help patients and families cope with the challenges of diagnosis and treatment, offering valuable resources throughout the cancer journey.

• #79 Efficacy of Peptide Receptor Radionuclide Therapy for Esthesioneuroblastoma | Journal of Nuclear Medicine

  https://jnm.snmjournals.org/content/61/9/1326

  Esthesioneuroblastoma is rare, with limited therapeutic options when unresectable or metastatic; however, expression of somatostatin receptors qualifies it for peptide receptor radionuclide therapy (PRRT). […] PRRT shows promising efficacy and moderate survival duration in unresectable locally advanced or metastatic esthesioneuroblastoma warranting larger cohort studies incorporating measures of quality of life. […] PRRT with radiolabeled somatostatin analogs appears to be a safe and effective option for unresectable, locally extensive, or metastatic esthesioneuroblastoma. Case selection depends on symptoms, SSR expression, disease volume, and prior intervention. In our limited series, PRRT improved symptoms and provided promising disease control and encouraging survival duration. Further prospective studies incorporating formal quality-of-life assessments and standardized response assessment are warranted.

• #80 Lutetium 177‑DOTA‑TATE therapy for esthesioneuroblastoma: A case report

  https://www.spandidos-publications.com/10.3892/etm.2016.3732

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignant tumor that accounts for 3% of all tumors of the nasal cavity. […] Common treatment strategies for ENB include resection and adjuvant radiotherapy and/or chemotherapy (combined treatment); however, the rate of recurrence is high. […] The current study described the case of a 74-year-old female with numerous recurrences of ENB following multiple treatments and without possibility of resection. The patient was treated with the radiolabeled somatostatin analogue, 177LutetiumDOTAoctreotate (177LuDOTATATE), which successfully controlled the disease. This suggests that 177LuDOTATATE is a potential treatment for ENB and may represent an effective alternative and novel therapeutic strategy for this disease. […] An effective standard treatment for ENB has yet to be established.

• #81 Lutetium 177‑DOTA‑TATE therapy for esthesioneuroblastoma: A case report

  https://www.spandidos-publications.com/10.3892/etm.2016.3732

  Currently, treatment with radionuclides bound to somatostatin analogues is performed in selected patients with neuroendocrine tumors, with considerable response. […] The present study described the case of a 74-year-old female with numerous recurrences of ENB following multiple treatments and without possibility of resection, who was successfully treated with 177Lu-DOTA-TATE. […] In conclusion, the current case report indicates that treatment with radiolabeled somatostatin analogues may be an effective alternative in similar cases where the neoplastic disease is inoperable and metastatic. This therapy was able to successfully control the disease, indicating that it may be a novel therapeutic strategy for this pathology.

• #82 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  External Beam Radiation: This method uses high-energy beams focused on the tumor, and advanced techniques like Intensity-Modulated Radiation Therapy (IMRT) help focus the radiation on the cancer while protecting healthy tissue. […] Proton Therapy: Proton therapy delivers radiation directly to the tumor with minimal impact on surrounding tissues, making it beneficial for tumors located near vital structures. […] Chemotherapy is typically used when the cancer has spread or alongside surgery and radiation to improve their effectiveness. […] Combination with Other Treatments: Chemotherapy may shrink the tumor before surgery (neoadjuvant) or help prevent recurrence after surgery (adjuvant). Common drugs include cisplatin and etoposide. […] Clinical Trials and Targeted Therapy: Ongoing research is exploring new treatments, including therapies designed to target specific cancer pathways.

• #83 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  Emerging Treatments: Targeted therapy and immunotherapy are being studied in clinical trials, offering hope for patients with recurrent or treatment-resistant tumors. These therapies aim to be more precise and cause fewer side effects than traditional methods. […] Managing the side effects of treatment and ensuring quality of life is essential in one’s recovery journey. […] Pain, nausea, and fatigue can be addressed with medications and supportive therapies. Post-surgical rehabilitation may be needed to help regain functions such as speech or motor skills, particularly if the surgery impacts critical areas. […] Counseling and support groups are available to help patients and families cope with the challenges of diagnosis and treatment, offering valuable resources throughout the cancer journey.

• #84 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  Emerging Treatments: Targeted therapy and immunotherapy are being studied in clinical trials, offering hope for patients with recurrent or treatment-resistant tumors. These therapies aim to be more precise and cause fewer side effects than traditional methods. […] Managing the side effects of treatment and ensuring quality of life is essential in one’s recovery journey. […] Pain, nausea, and fatigue can be addressed with medications and supportive therapies. Post-surgical rehabilitation may be needed to help regain functions such as speech or motor skills, particularly if the surgery impacts critical areas. […] Counseling and support groups are available to help patients and families cope with the challenges of diagnosis and treatment, offering valuable resources throughout the cancer journey.

• #85 Esthesioneuroblastoma Treatment | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/treatment

  Supportive care is an essential component of treatment, helping patients manage side effects and maintain their quality of life. […] The risk of recurrence is a major concern with esthesioneuroblastoma. Regular follow-up appointments are crucial for monitoring any signs of the tumor returning. […] Treating esthesioneuroblastoma involves a combination of surgery, radiation, and sometimes chemotherapy. Each patient’s treatment plan is personalized to ensure the best possible outcome, focusing on complete tumor removal while managing side effects and maintaining quality of life. […] With advances in treatment techniques and ongoing research, there is hope for improved outcomes and a brighter future for those affected by this rare cancer. […] Surgery is the primary treatment for esthesioneuroblastoma, with the goal of complete tumor removal to minimize recurrence risk.

• #86 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  Emerging Treatments: Targeted therapy and immunotherapy are being studied in clinical trials, offering hope for patients with recurrent or treatment-resistant tumors. These therapies aim to be more precise and cause fewer side effects than traditional methods. […] Managing the side effects of treatment and ensuring quality of life is essential in one’s recovery journey. […] Pain, nausea, and fatigue can be addressed with medications and supportive therapies. Post-surgical rehabilitation may be needed to help regain functions such as speech or motor skills, particularly if the surgery impacts critical areas. […] Counseling and support groups are available to help patients and families cope with the challenges of diagnosis and treatment, offering valuable resources throughout the cancer journey.

• #87 Esthesioneuroblastoma Treatment | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/treatment

  Supportive care is an essential component of treatment, helping patients manage side effects and maintain their quality of life. […] The risk of recurrence is a major concern with esthesioneuroblastoma. Regular follow-up appointments are crucial for monitoring any signs of the tumor returning. […] Treating esthesioneuroblastoma involves a combination of surgery, radiation, and sometimes chemotherapy. Each patient’s treatment plan is personalized to ensure the best possible outcome, focusing on complete tumor removal while managing side effects and maintaining quality of life. […] With advances in treatment techniques and ongoing research, there is hope for improved outcomes and a brighter future for those affected by this rare cancer. […] Surgery is the primary treatment for esthesioneuroblastoma, with the goal of complete tumor removal to minimize recurrence risk.

• #88 Esthesioneuroblastoma: A Comprehensive Review of Diagnosis, Management, and Current Treatment Options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30862589/

  Surgical resection followed by radiotherapy is the standard for treatment for higher-grade lesions. […] The endoscopic endonasal approach is gaining further recognition with more favorable outcomes and better survival than for open surgery. […] Postoperative radiotherapy is associated with the highest overall survival and shows benefit for patients with higher-stage disease and those who receive chemotherapy. […] Recurrence rates after treatment vary drastically in the literature and, therefore, prolonged follow-up with repeated imaging is recommended. […] Lifelong surveillance is recommended because of late recurrences associated with this tumor.

• #89 Esthesioneuroblastoma: A Comprehensive Review of Diagnosis, Management, and Current Treatment Options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30862589/

  Surgical resection followed by radiotherapy is the standard for treatment for higher-grade lesions. […] The endoscopic endonasal approach is gaining further recognition with more favorable outcomes and better survival than for open surgery. […] Postoperative radiotherapy is associated with the highest overall survival and shows benefit for patients with higher-stage disease and those who receive chemotherapy. […] Recurrence rates after treatment vary drastically in the literature and, therefore, prolonged follow-up with repeated imaging is recommended. […] Lifelong surveillance is recommended because of late recurrences associated with this tumor.

• #90 Esthesioneuroblastoma: A Comprehensive Review of Diagnosis, Management, and Current Treatment Options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30862589/

  Surgical resection followed by radiotherapy is the standard for treatment for higher-grade lesions. […] The endoscopic endonasal approach is gaining further recognition with more favorable outcomes and better survival than for open surgery. […] Postoperative radiotherapy is associated with the highest overall survival and shows benefit for patients with higher-stage disease and those who receive chemotherapy. […] Recurrence rates after treatment vary drastically in the literature and, therefore, prolonged follow-up with repeated imaging is recommended. […] Lifelong surveillance is recommended because of late recurrences associated with this tumor.

• #91 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #92 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #93 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #94 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #95 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #96 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #97 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #98 Esthesioneuroblastoma: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/278047-overview

  Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare neoplasm originating from olfactory neuroepithelium. […] Despite the difficulties associated with the treatment of ENB, evolving treatment modalities, including surgery, radiation, and adjuvant chemotherapy, have contributed to better management of ENB and longer survival of these patients. […] The prognosis depends on the magnitude of the disease on initial diagnosis. […] Survival data categorized according to treatment modality favored regimens that include surgery. […] The most frequent recurrence is local, with rates from 20-40%. […] Craniofacial resection followed by radiation seems to result in fewer recurrences, a rate of approximately 10%. […] Salvage after local recurrence is possible in one third to one half of cases. […] Regional recurrence, while disease at the primary site remains under control, occurs in 15% of cases and is salvageable by further treatment in 25-50% of cases. […] Distant metastasis with locoregional control occurs infrequently (8%) and carries a dismal prognosis.

• #99 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Due to locally infiltrative nature of the disease, surgically clear margins are difficult to achieve. Thus there is a role of adjuvant RT to minimize the risk of local recurrence. […] The role of chemotherapy is not very clear in adjuvant settings in early tumors, but in locally advanced and metastatic tumors it has a definitive role. […] Kadish A staged tumors requires all the three modalities. Neoadjuvant approach (CT/RT/concurrent CT-RT) is preferred. […] Systemic chemotherapy and palliative RT to local site and metastatic sites are advised. Palliative care should be incorporated for improving the quality of life. […] Local recurrence and/or distant metastases remain the main problem in the management of ENB. […] The most important prognostic factors influencing the outcome reported in ENB are Hyams grade, positive lymph nodes, Kadish stage, extent of resection and postoperative RT with atleast 54 Gy. […] Most of the patients of ENB present in locally advanced stage and the optimal management depends on the cooperation between clinicians, surgeons, radiologists and pathologists from establishing diagnosis to organizing the therapeutic strategy.

• #100

  https://medicaljournalssweden.se/actaoncologica/article/view/28150

  A retrospective review was conducted on 13 patients with esthesioneuroblastoma (ENB), treated at our institution from 1977 to 1997. […] Five-year disease-specific survival was found to be 51%. […] This indicates the need for good primary control in local as well as distant disease. […] The role of pre- versus postoperative radiotherapy to secure good local control is discussed and compared with the literature, and treatment guidelines are proposed. […] The tumours were graded according to the Hyams’ classification and its importance as a prognostic factor is briefly discussed.

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

  https://www.jcancer.org/v09p0174.htm

  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. […] 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. […] Surgical resection followed by radiotherapy has been shown to achieve optimal local control and overall survival. […] Patients with confirmed ENB diagnosis were treated with surgical resection, RT and chemotherapy or their combinations. […] The technique of RT included 2D, 3D and intensity modulated radiation.

• #102 Long-term analysis of multimodality treatment outcomes and prognosis of esthesioneuroblastomas: a single center results of 138 patients | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-020-01667-4

  The most widely accepted treatment approach was multimodality strategy combining surgery with radiotherapy. […] Compared with single modality therapy, the combination of modality therapy elicited superior OS (80.2% vs. 43.1%, p 0.001), LRFFS (85.3% vs. 57.7%, p 0.001) and DMFS (80.0% vs. 49.9%, p 0.001). […] The best 5-year OS, LRFFS and DMFS were also observed in S+CCRT group for patients with Kadish C disease and for those with positive margin. […] The addition of concurrent chemotherapy to radiotherapy alone also yielded higher survival results, which suggested that concurrent chemoradiation might be a good alternative method when surgery cannot be performed. […] The role of chemotherapy remained uncertain and there was no standard chemotherapy regimen. […] The combination of surgery and current chemoradiotherapy achieved the best prognoses in our results, and the value of current chemotherapy needed to be verified by additional data sets.

• #103

  https://link.springer.com/article/10.1007/s11864-005-0029-7

  Esthesioneuroblastoma is a rare tumor for which the published literature does not provide an evidence-based consensus treatment approach. Multimodality therapy including a combination of surgery and radiation appears to provide the best disease-free and overall survival. Surgical resection should proceed through a craniofacial approach if possible. The role of chemotherapy in the initial treatment paradigm is less clear. Chemotherapy should not be used as single-modality therapy for initial treatment but may provide additional benefit when used in combination with radiation and surgery, particularly in advanced-stage disease. Combination chemotherapy should be considered as initial therapy for unresectable tumors and metastatic disease, and as salvage therapy in disease recurrence. […] Multimodality therapy including radiotherapy and chemotherapy improves event free survival in stage C esthesioneuroblastoma.

• #104 Esthesioneuroblastoma: A Comprehensive Review of Diagnosis, Management, and Current Treatment Options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30862589/

  Surgical resection followed by radiotherapy is the standard for treatment for higher-grade lesions. […] The endoscopic endonasal approach is gaining further recognition with more favorable outcomes and better survival than for open surgery. […] Postoperative radiotherapy is associated with the highest overall survival and shows benefit for patients with higher-stage disease and those who receive chemotherapy. […] Recurrence rates after treatment vary drastically in the literature and, therefore, prolonged follow-up with repeated imaging is recommended. […] Lifelong surveillance is recommended because of late recurrences associated with this tumor.

• #105 Esthesioneuroblastoma Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/overview

  Emerging Treatments: Targeted therapy and immunotherapy are being studied in clinical trials, offering hope for patients with recurrent or treatment-resistant tumors. These therapies aim to be more precise and cause fewer side effects than traditional methods. […] Managing the side effects of treatment and ensuring quality of life is essential in one’s recovery journey. […] Pain, nausea, and fatigue can be addressed with medications and supportive therapies. Post-surgical rehabilitation may be needed to help regain functions such as speech or motor skills, particularly if the surgery impacts critical areas. […] Counseling and support groups are available to help patients and families cope with the challenges of diagnosis and treatment, offering valuable resources throughout the cancer journey.

• #106 Esthesioneuroblastoma: Multimodal management and review of literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4568526/

  Due to locally infiltrative nature of the disease, surgically clear margins are difficult to achieve. Thus there is a role of adjuvant RT to minimize the risk of local recurrence. […] The role of chemotherapy is not very clear in adjuvant settings in early tumors, but in locally advanced and metastatic tumors it has a definitive role. […] Kadish A staged tumors requires all the three modalities. Neoadjuvant approach (CT/RT/concurrent CT-RT) is preferred. […] Systemic chemotherapy and palliative RT to local site and metastatic sites are advised. Palliative care should be incorporated for improving the quality of life. […] Local recurrence and/or distant metastases remain the main problem in the management of ENB. […] The most important prognostic factors influencing the outcome reported in ENB are Hyams grade, positive lymph nodes, Kadish stage, extent of resection and postoperative RT with atleast 54 Gy. […] Most of the patients of ENB present in locally advanced stage and the optimal management depends on the cooperation between clinicians, surgeons, radiologists and pathologists from establishing diagnosis to organizing the therapeutic strategy.

• #107 Endoscopic treatment of esthesioneuroblastoma | Brazilian Journal of Otorhinolaryngology

  https://www.bjorl.org/en-endoscopic-treatment-esthesioneuroblastoma-articulo-S1808869415308065

  Management of this tumor is uncertain because of the paucity of cases and advances in diagnostic and treatment methods. Current approaches include en bloc surgery, single or combined endoscopic procedures, radiotherapy, and chemotherapy. […] Endoscopic resection of the primary tumor with equivalent margins to those of open surgery was possible in all patients. […] All patients were treated with postoperative supplementary external radiotherapy, which was started in the third to fourth week after surgery. […] The postoperative morbidity related to endoscopy was minor. […] Esthesioneuroblastoma is a potentially curable malignancy with surgery and radiotherapy. Endoscopic techniques result in significant esthetic and functional gains, reduced recovery times, lower costs, and less morbidity and mortality compared to the conventional approach.

• #108 Esthesioneuroblastoma Treatment | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/esthesioneuroblastoma/treatment

  Supportive care is an essential component of treatment, helping patients manage side effects and maintain their quality of life. […] The risk of recurrence is a major concern with esthesioneuroblastoma. Regular follow-up appointments are crucial for monitoring any signs of the tumor returning. […] Treating esthesioneuroblastoma involves a combination of surgery, radiation, and sometimes chemotherapy. Each patient’s treatment plan is personalized to ensure the best possible outcome, focusing on complete tumor removal while managing side effects and maintaining quality of life. […] With advances in treatment techniques and ongoing research, there is hope for improved outcomes and a brighter future for those affected by this rare cancer. […] Surgery is the primary treatment for esthesioneuroblastoma, with the goal of complete tumor removal to minimize recurrence risk.

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