Esthesioneuroblastoma: The impact of treatment modality

被引:60
作者
Chao, KSC
Kaplan, C
Simpson, JR
Haughey, B
Spector, GJ
Sessions, DG
Arquette, M
机构
[1] Washington Univ, Med Ctr, Mallinckrodt Inst Radiol, Radiat Oncol Ctr, St Louis, MO 63110 USA
[2] Washington Univ, Med Ctr, Dept Otolaryngol, St Louis, MO 63110 USA
[3] Washington Univ, Med Ctr, Dept Internal Med, St Louis, MO 63110 USA
来源
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2001年 / 23卷 / 09期
关键词
esthesioneuroblastoma; radiation therapy; chemotherapy;
D O I
10.1002/hed.1107.abs
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background. We evaluated the impact of treatment modality on esthesioneuroblastoma. Methods. Between 1976 and 1996, 25 patients with esthesioneuroblastoma were treated at Mallinckrodt Institute of Radiology. There were 11 male and 14 female patients; their ages ranged from 16 to 73 years (median, 57 years). The tumors were Kadish stage A in 3, Stage B in 13, C in 8, and modified D in 1 (cervical nodal metastasis). Seventeen patients were treated with surgery and radiation therapy, six were treated with irradiation alone, and two were treated with surgery only. Eight patients received neoadjuvant chemotherapy. Median follow-up was 8 years (range, 2-24 years). Results. The 5-year actuarial overall survival, disease-free survival, and local tumor control rates were 66.3%, 56.3%, and 73.0%, respectively. Kadish stage was not a significant prognosticator for local control or disease-free survival. Five-year local control rates were 87.4% for the combination of surgery and radiation therapy and 51.2% for irradiation alone. Two patients with Kadish stage A and B disease underwent surgical resection alone; both failed locally. In contrast, 33.3% of patients (three of nine) with Kadish stage A or B disease who received adjuvant radiation therapy had a local recurrence develop. With adjuvant radiation therapy, the surgical margin status did not influence local tumor control. Among the eight patients who received neoadjuvant chemotherapy, six patients showed no response, one had partial response, and one showed a complete response. Conclusions. Surgical resection plus adjuvant radiation therapy yielded the best treatment outcome. More effective chemotherapy agents with a reproducible effectiveness are needed for patients with locally advanced esthesioneuroblastoma. (C) 2001 John Wiley & Sons, Inc.
引用
收藏
页码:749 / 757
页数:9
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