Outcome and Optimal Treatment for Esthesioneuroblastoma in the Era of Intensity-Modulated Radiation Therapy: A Single-Center Experience

Abstract

Tongxin Liu,1– 4,* Quanquan Sun,1– 3,* Weifeng Qin,1– 4 Xiaozhong Chen,1– 4 Qiaoying Hu1– 4 1Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang 310022, People’s Republic of China; 2Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, People’s Republic of China; 3Key Laboratory of Radiation Oncology in Zhejiang Province, Hangzhou, Zhejiang 310022, People’s Republic of China; 4Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, Zhejiang 310022, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiaoying HuDepartment of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang 310022, People’s Republic of ChinaEmail [email protected]: Esthesioneuroblastoma (ENB) is a type of rare malignant neoplasm of the sinonasal cavity. Optimal treatment for ENB is still controversial. A retrospective study was conducted to identify the clinical outcome and optimal treatment for ENB in the era of intensity-modulated radiation therapy (IMRT).Patients and Methods: Between December 2006 and August 2018, 37 patients with ENB without distant metastasis who underwent neoadjuvant chemotherapy followed by chemoradiotherapy (C+RC) or surgery followed by radiotherapy or chemoradiotherapy (S+R/RC) were retrospectively reviewed at our center.Results: The median follow-up period was 63.7 months (range, 13.2– 111.5 months). Five-year overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were similar between treatment arms (P values > 0.05). With a multivariate analysis, a Karnofsky Performance Status (KPS) of ≤ 80 was a prognostic factor for poor five-year OS. A KPS of ≤ 80 and Kadish class C–D tumors were prognostic factors for poor PFS. A KPS of ≤ 80 was a prognostic factor for poor LRFS. When KPS was ≤ 80 and tumors were Kadish class C–D, T3– 4 and N1 were prognostic factors for poor DMFS. Subgroup analyses also demonstrated that the two treatment arms exhibited similar trends for OS, PFS, LRFS, and DMFS, excluding patients with N1 or Kadish class A–B tumors (P values > 0.05).Conclusion: In the era of IMRT, S+R/RC failed to improve the outcomes of patients with ENB. C+RC may be a feasible treatment option for patients with ENB.Keywords: olfactory neuroblastoma, neoadjuvant chemotherapy, precise radiotherapy

Keywords

• olfactory neuroblastoma
• neoadjuvant chemotherapy
• precise radiotherapy