Neoadjuvant etoposide, ifosfamide, and cisplatin for the treatment of olfactory neuroblastoma.
BACKGROUND
The optimal chemotherapy regimen for the treatment of olfactory neuroblastoma has not been clearly defined. The purpose of the current study was to evaluate the efficacy of neoadjuvant chemotherapy with the combination of etoposide, ifosfamide, and cisplatin (VIP) for patients with olfactory neuroblastoma.


METHODS
Eleven consecutive patients with newly diagnosed olfactory neuroblastoma were treated with etoposide (75 mg/m2), ifosfamide (1000 mg/m2), and cisplatin (20 mg/m2) all administered intravenously on Days 1-5. Cycles were repeated every 21 days. Patients were excluded from analysis if they had previously received surgery or radiotherapy.


RESULTS
Nine patients achieved objective responses (objective response rate, 82%; 95% confidence interval, 52-95%), which included 2 complete responses and 7 partial responses. The major side effect was hematologic toxicity, with Grade 3/4 neutropenia observed after the receipt of 37% of all cycles and febrile neutropenia observed after the receipt of 2 cycles. All toxic events were reversible, and no chemotherapy-related deaths were documented. The median survival period was 18 months (range, 3-45 months).


CONCLUSIONS
Neoadjuvant VIP chemotherapy was active in the treatment of olfactory neuroblastoma.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Dong-Wan
DW
Kim
Yo-Han
YH
Jo
Jee Hyun
JH
Kim
Hong-Gyun
HG
Wu
Chae Seo
CS
Rhee
Chol Hee
CH
Lee
Tae-You
TY
Kim
Dae Seog
DS
Heo
Yung-Jue
YJ
Bang
Noe Kyeong
NK
Kim
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018304:Esthesioneuroblastoma, Olfactory / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology*; D020360:Neoadjuvant Therapy; D009669:Nose Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide