TREATMENT OF OLFACTORY NEUROBLASTOMA - A REPORT OF 11 CASES

Eleven olfactory neuroblastomas treated at Helsinki University Central Hospital between 1970 and 1991 were reviewed retrospectively. The dis tribution of the patients was according to Morita's staging (modified Kadish's classification) as follows: one stage A, one stage B and nine stage C. Tumor resections were performed in all cases, and five were considered radical. All patients received radiotherapy: total doses ra nged from 42 to 70 Gy. At least a short treatment response was achieva ble in all cases. Chemotherapy was given to two patients: one remissio n was obtained by methotrexate with leucovorin rescue and doxorubicin for residual disease after radiotherapy. Distant metastases were obser ved in three cases, two in the lungs and one intraperitoneally. After a median follow-up of 63 (range, 6-140) months, five patients are aliv e and well, two patients have died with no evidence of disease; two pa tients who received only 42 and 50 Gy in 5 and 6 weeks have died of lo cal recurrences and two of distant metastases. None of the patients wi th advanced (stage B or C) disease who received radical radiotherapy ( greater than or equal to 60 Gy given in 6 to 9 weeks) developed local recurrence. The increasing incidence of distant metastasis justifies a n intensification of initial treatment, especially in stage C disease.