Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review

Publication date: Available online 20 October 2017
Source:Acta Otorrinolaringológica Española
Author(s): Ricardo Bartel, Xavier Gonzalez-Compta, Enric Cisa, Francesc Cruellas, Alberto Torres, Aleix Rovira, Manel Manos
Introduction and objectivesOlfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/−adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature.MethodsA retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution.Results9 patients were included. Mean follow-up of 52.5 months (range 10–107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%.ConclusionNeoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications.



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Cutaneous atypical papular CD8+ lymphoproliferative disorder at acral sites in a renal transplant patient

Summary

A 20-year-old woman presented with a 2-month history of an acute symmetrical eruption, manifesting as asymptomatic ill-defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2 months post-transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD8+ lymphocytes as well as primary cutaneous acral CD8+ T-cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016). The latter disorder has been described to occur at acral sites in immunocompetent patients, whereas the former has previously been described only in patients infected with human immunodeficiency virus. The lesions in our patient healed after topical treatment with corticosteroids and alteration of immunosuppressive therapy, supporting the role of immunosuppression in this case. We classified our patient's condition as lying in the spectrum of the aforementioned two conditions, but the relationship between both diseases remains to be clarified. Awareness of these unusual conditions may prevent the use of unnecessary aggressive therapies in similar patients.

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Association of Mannose-Binding Lectin rs1800450 and Tumor Necrotic Factor-α rs1800620 Polymorphism with Helicobacter pylori in Type II Diabetes Mellitus

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Oct 2017, Vol. 36, No. 5: 236-241.


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Anti-hLCN6 Monoclonal Antibody

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Oct 2017, Vol. 36, No. 5: 242-242.


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A new endoscopic technique to close big nasal septal perforations: prospective evaluation of the double meat hook technique in 19 consecutive cases

Abstract

Despite the variety of surgical techniques available to close big symptomatic septum perforations, closure rates of 30 to 70% indicate the difficulty of obtaining a good end result.

The double meat hook technique is a new endoscopically assisted technique that delivers excellent visualization and control of mucosal flap elevation, extension and suturing.

Mucosa from the nasal floor, lateral nasal wall and inferior turbinate bone are valuable donor site extensions.

There is no need for additional incisions into the nasal septal mucosa in order to perform a tension-free closure. Preservation of the structural integrity and blood supply of the mucosal flaps, possibly contributes to a high closure rate and delivers a physiological result.

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Current Use of Baseline Medical Treatment in Chronic Rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)

Abstract

Objectives

According to clinical and comissioning guidelines for chronic rhinosinusitis (CRS), patients being referred to secondary care should have failed primary medical treatment with nasal douching (ND) and intranasal corticosteroids (INCS). The study objectives were to identify the rate of specific medical therapy in CRS patients and establish any differences in medication use, for both CRS and associated medical conditions, between CRS phenotypes.

Design and setting

Case-control study in a secondary care setting.

Methods

Participant-reported study-specific questionnaire capturing free text data on current medication use at the time of study entry. Qualitative interviews with 21 participants also explored their experience of CRS and its management.

Particpants

Patients with both without (CRSsNPs) and with polyps (CRSwNPs).

Main outcome measures

Reported use of CRS-related and non-related medications.

Results

Within a total of 1243 CRS participants, current INCS usage was low (18% in CRSwNPs, 12% in CRSsNPs); ND was being performed by only 1% of all participants. Bronchodilators and inhaled corticosteroids use was significantly higher in CRSwNPs participants (p < 0.0001). Antidepressants use was significantly higher in CRSsNPs (14% versus 7%, p < 0.0002). There were no significant regional variations in rates of INCS use, nor any significant influence of social deprivation.

Conclusions

The current use of baseline medical therapy in CRS appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some ENT specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.

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Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Abstract

Background

Grass pollen–related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood.

Methods

We examined 1120 children (age 4–18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD^™). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA.

Results

The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass-specific serum IgE and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SAR, and complex profiles were associated with longer disease duration.

Conclusions

In a large pediatric population, the complexity of IgE sensitization profiles against Phleum pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7 and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response.

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