Olfactory neuroblastoma. Observations on seven patients treated with radiation therapy and review of the literature.

Seven patients with olfactory neuroblastoma were treated, using the staging classification proposed by Kadish (stage A two patients, stage B one, stage C three, and local recurrence one patient). Treatment was not uniform. Radiation therapy was employed initially as the only treatment modality in three patients who had stage A, B, and C, respectively. In one instance, it was used to treat a local recurrence after surgical treatment. Surgery and radiation therapy was employed in three patients: one with stage A and two with stage C. Chemotherapy was used as an adjuvant to radiation and surgery in one patient with stage C, and in three individuals, it was used for advanced disease. Four of the seven patients are alive without evidence of disease from 23 months to 16 years 8 months after treatment. A review of 11 series from the recent medical literature is presented. It is essential to follow these patients for long periods of time because of the slow growth and the propensity of local recurrence that some of these tumors have. The actual tendency in the management of this neoplasm seems to be combined therapy with surgery and radiation. The role of adjuvant chemotherapy is not well established, but has been recommended for locally advanced disease.