Abstract：Objective To investigate the therapeutic effects of various surgical procedures combined with radiotherapy in treatment of esthesioneuroblastoma. Methods The clinical data of 53 patients with locally advanced esthesioneuroblastoma who underwent surgery combined with radiotherapy in our hospital were analyzed retrospectively, and the tumor resection rate and therapeutic effect were compared between various surgical procedures. Percentages were compared using the chi-square test. The survival data were estimated using the Kaplan-Meier methods. Results The median follow-up was 70 months, and the 5-year overall survival and disease-free survival were 86% and 74%, respectively. The patients were divided into the open surgery group with 31 patients and the endoscopic surgery group with 22 patients. The endoscopic surgery group had a higher residual tumor rate than the open surgery group (64% vs. 42%,P=0.166), and the patients with Kadish stage C disease in the endoscopic surgery group had a residual tumor rate of 78%. The 5-year overall survival and disease-free survival for patients with a complete tumor resection and those with residual tumor were 91% vs. 80% and 82% vs. 67%, respectively. Although the endoscopic surgery group had a higher residual tumor rate than the open surgery group, the 5-year overall survival and disease-free survival were 83% vs. 86%(P=0.560) and 77% vs. 71%(P=0.188),respectively. The analysis showed that in the endoscopic surgery group, more patients received a dose higher than 66 Gy in the postoperative radiotherapy (P=0.011), and the 5-year overall survival and disease-free survival for patients receiving>66 Gy and ≤66 Gy were 100% vs. 67%(P=0.092) and 100% vs. 50%(P=0.052),respectively. Conclusions Surgery combined with radiotherapy can achieve a good therapeutic effect in patients with modified Kadish stage B/C esthesioneuroblastoma. The indications for endoscopic surgery should be followed strictly, and at present, endoscopic surgery is not suitable for the patients with Kadish stage C esthesioneuroblastoma or with involvement of the frontal sinus. As for the patients with unknown resection margin status, the dose of postoperative radiotherapy should be more than 66 Gy.
Yin Zhenzhen,Gao Li,Luo Jingwei et al. Therapeutic effects of various surgical procedures combined with radiotherapy in treatment of Kadish stage B/C esthesioneuroblastoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 100-104.
2016, Vol. 25 
