title: Combination chemotherapy (cyclophosphamide, doxorubicin, and vincristine with continuous-infusion cisplatin and etoposide) and radiotherapy with stem cell support can be beneficial for adolescents and adults with estheisoneuroblastoma.
abstract: BACKGROUND
  Adolescent-onset and adult-onset esthesioneuroblastoma is a rare disease and is considered incurable. In many patients, local resection and radiation are chosen as clinical therapy with or without chemotherapy. It was reported previously that local resection and radiotherapy led to temporary remission and, in many patients, recurrent disease. Although combination with chemotherapy has been regarded as promising, an effective regimen has not been established. In the current study, the authors investigated the effect and tolerability of the combination of chemotherapy, radiotherapy, and peripheral blood stem cell transplantation (PBSCT).
  
  
  METHODS
  The study population included 12 patients with adolescent-onset and adult-onset esthesioneuroblastoma classified as Kadish Stage A-D. The patients received two cycles of combination chemotherapy, which consisted of cyclophosphamide, doxorubicin, and vincristine (CAD) with continuous-infusion cisplatin and etoposide (CVP). This was combined with radiotherapy with or without PBSCT.
  
  
  RESULTS
  Nine of 12 patients (75%) obtained more than a partial response after only 2 cycles of chemotherapy. After radiation with or without PBSCT, six patients obtained a complete remission (CR). The longest survival was > 3 years. All patients who underwent PBSCT obtained a CR. The most severe side effects were loss of sodium and potassium induced by cisplatin-related renal tubular distress. Those abnormalities were temporary, and all patients recovered.
  
  
  CONCLUSIONS
  The chemotherapy regimen with CADO and CVP does not require continuation for a long time and is very effective and tolerable for patients with adolescent-onset and adult-onset esthesioneuroblastoma. The combination with radiotherapy and PBSCT may lead to a CR without facial disfigurement. In this report, the authors discuss the feasibility and efficacy of this multidisciplinary approach.
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Toshima-ku, Tokyo.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mishima
authors.forename: Eijiro
authors.initials: E
authors.lastname: Nagasaki
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Terui
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Irie
authors.forename: Shunji
authors.initials: S
authors.lastname: Takahashi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.forename: Masahiko
authors.initials: M
authors.lastname: Oguchi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Shinetsu
authors.initials: S
authors.lastname: Kamata
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Hatake
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D018304:Esthesioneuroblastoma, Olfactory / Q000628:therapy*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin