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Abstract Objective This study aimed to compare the historical incidence rate of severe oral mucositis (OM) in head and neck cancer patients undergoing definitive concurrent chemoradiation therapy (CRT) versus a prospective cohort of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) treated with prophylactic photobiomodulation therapy (PBMT). Methods This US‐based, institutional, single‐arm, phase Ⅱ prospective clinical trial was initiated in 50 patients (age ≥ 18 years, Karnofsky Performance Scale Index > 60, with locally advanced HNSCC (excluding oral cavity) receiving definitive or adjuvant radiation therapy (RT) with concurrent platinum‐based chemotherapy (CT). PBMT was delivered three times per week throughout RT utilizing both an intraoral as well extraoral delivery system. Primary outcome measure was incidence of severe OM utilizing both the National Cancer Institute Common Toxicity Criteria, version 4.0 (NCI‐CTCAE) Grade ≥3 and the World Health Organization Mucositis Grading Scale (WHO) Grade ≥3 versus historical controls; secondary outcome measures included time to onset of severe OM following therapy initiation. Results At baseline, all patients included in final analysis (N = 47) had OM Grade 0. Average RT and CT dose was (66.3 ± 5.1) Gy and (486.1 ± 106.8) mg/m2, respectively. Severe OM was observed in 11 of 47 patients (23%, confidence interval: 12, 38). OM toxicity grade trended upward during treatment, reaching a maximum at 7 weeks (WHO: 1.8 vs. NCI‐CTCAE: 1.7). Subsequently, OM grade returned to baseline 3 months following completion of RT. The mean time to onset of severe OM was (35 ± 12) days. The mean time to resolution of severe OM was (37 ± 37) days. Conclusions Compared to historical outcomes, PBMT aides in decreasing severe OM in patients with locally advanced HNSCC. PBMT represents a minimally invasive, prophylactic intervention to decrease OM as a major treatment‐related side effect.

Objective: Pediatric esthesioneuroblastoma (ENB) is a rare entity with only one previous report of an ectopic origin. Much of the research available regarding ENB is in the adult literature, with few studies focusing on the pediatric population. Here we report a case of ectopic pediatric ENB and review the literature regarding this unusual clinical entity. Methods: Case report (n = 1) describing presentation, operative findings, and clinical course followed by a literature review of ENB with a special focus on pediatric cases, including ectopic origins. Results: A 13-year-old boy presented with a unilateral nasal polyp without history of epistaxis. The patient underwent endoscopic resection with pathology revealing ENB. There was no tumor at the olfactory groove and was found to arise from the lateral nasal wall. The patient had postoperative proton beam therapy and no evidence of disease at his six-month follow up. Pediatric ENB is rare and often presents at a much more advanced stage than adult ENB. Due to the paucity of cases, its management follows that of conventional ENB including multimodality therapy with surgery and radiotherapy. Recurrences have been reported beyond five years, requiring long term follow up. Conclusions: Pediatric ectopic ENB is a rare clinical entity that requires a high index of suspicion for diagnosis. Multimodality therapy with surgery and radiotherapy is the standard of care, and patients should be counseled on long term follow up.