Dr. Ladra on the Treatment of Pediatric Esthesioneuroblastoma

Matthew Ladra, MD, director, Pediatric Radiation Oncology, Johns Hopkins Kimmel Cancer Center at Sibley Memorial Hospital, discusses the treatment of esthesioneuroblastoma in children.

Esthesioneuroblastoma is a rare malignancy of the nasal cavity, arising anywhere that epithelium is present. Although it is more common in adults, there are a few pediatric cases that arise. Treatment varies based on clinical presentation, how invasive the disease is, or how it appears under the microscope. Ladra says that in early stages, these patients are treated with surgery alone, but if the tumor has spread to the other side of the nasal cavity or is deemed aggressive, radiation is used.

Surgery, radiation, and chemotherapy have all been used in children with esthesioneuroblastoma. Compared to adults, there has been good response rates in pediatric patients, with about 60% to 80% responding to chemotherapy. Multimodality therapy seems to give the best results, Ladra says.