Department of Radiation Oncology,Cancer Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beijing 10021,ChinaCorresponding authors:Gao Li:Email:li_gao2008@outlook.com;Luo Jingwei:nqluo202@163.com
Abstract：Objective To evaluate the multimodal treatment outcomes and patterns of treatment failure in esthesioneuroblastoma at a single institution. Methods One hundred and twelve patients who were newly diagnosed with esthesioneuroblastoma but no distant metastasis in our institution from 1979 to 2014 were retrospectively analyzed. The treatment modes, outcomes, and patterns of treatment failure in these patients were analyzed. According to the modified Kadish staging system, the numbers of patients with stage A, B, C, and D esthesioneuroblastoma were 1, 23, 60, and 28, respectively. Fifty-one patients received surgery and postoperative radiotherapy with or without chemotherapy;forty-six patients received radiotherapy with or without chemotherapy;eleven patients received preoperative radiotherapy and surgery with or without chemotherapy;three patients received surgery with or without chemotherapy;one patient received chemotherapy alone. The survival rates were calculated using the Kaplan-Meier method. Results In all patients, the 5-year sample size was 44, and the 5-year overall survival (OS) and disease-free survival (DFS) rates were 66.4% and 54.7%, respectively. The 5-year OS and DFS rates were 91% and 82% in patients who received preoperative radiotherapy and surgery with or without chemotherapy, 80% and 66% in patients who received surgery and postoperative radiotherapy with or without chemotherapy, and 46% and 37% in patients who received radiotherapy with or without chemotherapy. Three patients treated with surgery alone had relapse of the disease;one patient treated with palliative chemotherapy survived 6 months. Treatment failed in 47(42%) out of 112 patients. In patients with failed treatment, 53% had distant metastasis as the first pattern of treatment failure, 36% had locoregional relapse, and 11% had concurrent distant metastasis and locoregional relapse. Conclusions Surgery combined with radiotherapy is still the recommended multimodal treatment regimen for esthesioneuroblastoma. The multimodal treatment achieves satisfactory local-regional control rate and treatment outcomes in the treatment of esthesioneuroblastoma. The major pattern of treatment failure is distant metastasis.
Yin Zhenzhen,Gao Li,Luo Jingwei et al. An analysis of multimodal treatment outcomes and patterns of treatment failure in esthesioneuroblastoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(5): 534-537.
[1] Broich G,Pagliari A,Ottaviani F.Esthesioneuroblastoma:a general review of the cases published since the discovery of the tumour in 1924[J].Anticancer Res,1997,17(4A):2683-2706. [2] Dulguerov P,Allal AS,Calcaterra TC.Esthesioneuroblastoma:a meta-analysis and review[J].Lancet Oncol,2001,2(11):683-690.DOI:10.1016/S1470-2045(01)00558-7. [3] Kane AJ,Sughrue ME,Rutkowski MJ,et al. Posttreatment prognosis of patients with esthesioneuroblastoma[J].J Neurosurg,2010,113(2):340-351.DOI:10.3171/2010.2.JNS091897. [4] Jethanamest D,Morris LG,Sikora AG,et al. Esthesioneuroblastoma:a population-based analysis of survival and prognostic factors[J].Arch Otolaryngol Head Neck Surg,2007,133(3):276-280.DOI:10.1001/archotol.133.3.276. [5] 赵路军,高黎,徐国镇,等.嗅神经母细胞瘤的预后因素和治疗结果分析[J].中华肿瘤杂志,2005,27(9):561-564.DOI:10.3760/j.issn:0253-3766.2005.09.015. [6] Platek ME,Merzianu M,Mashtare TL,et al. Improved survival following surgery and radiation therapy for olfactory neuroblastoma:analysis of the SEER database[J/OL].Radiat Oncol,2011,6(1):41[2014-12-22].http://WWW.ncbi.nlm.nih.gov/pmc/articles/PMC3098784/.DOI:10.1186/1748－717X-6-41. [7] Spaulding CA,Kranyak MS,Constable WC,et al. Esthesioneuroblastoma:a comparison of two treatment eras[J].Int J Radiat Oncol Biol Phys,1988,15(3):581-590.DOI:10.1016/0360-3016(88)90298-2. [8] Howell MC,Branstetter BT,Snyderman CH.Patterns of regional spread for esthesioneuroblastoma[J].Am J Neuroradiol,2011,32(5):929-933.DOI:10.3174/ajnr. A2401. [9] Kadish S,Goodman M,Wang CC.Olfactory neuroblastoma. A clinical analysis of 17 cases[J].Cancer,1976,37(3):1571-1576. [10] Demiroz C,Gutfeld O,Aboziada M,et al. Esthesioneuroblastoma:is there a need for elective neck treatment?[J].Int J Radiat Oncol Biol Phys,2011,81(4):255-261.DOI:10.1016/j.ijrobp.2011.03.036. [11] Noh OK,Lee SW,Yoon SM,et al. Radiotherapy for esthesioneuroblastoma:is elective nodal irradiation warranted in the multimodality treatment approach?[J].Int J Radiat Oncol Biol Phys,2011,79(2):443-449.DOI:10.1016/j.ijrobp.2009.10.067. [12] Sohrabi S,Drabick JJ,Crist H,et al. Neoadjuvant concurrent chemoradiation for advanced esthesioneuroblastoma:a case series and review of the literature[J].J Clin Oncol,2011,29(13):358-361.DOI:10.1200/JCO.2010.30.9278.
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