Hollen Tyler R, Morris Christopher G, Kirwan Jessica M, Amdur Robert J, Werning John W, Vaysberg Mikhail, Mendenhall William M
Departments of *Radiation Oncology †Otolaryngology, University of Florida College of Medicine, Gainesville, FL.
Am J Clin Oncol. 2015 Jun;38(3):311-4. doi: 10.1097/COC.0b013e31829b5631.
Esthesioneuroblastoma is an uncommon cancer of the nasal cavity. We describe the outcomes for 26 patients treated with curative intent with photon radiotherapy (RT) at the University of Florida.
Between May 1972 and June 2007, 26 patients received RT for previously untreated esthesioneuroblastoma of the nasal cavity. Sixteen patients were males and 10 were females with a median age of 55 years (range, 3 to 82 y). The modified Kadish stage distribution was: B, 7 patients; C, 17 patients; and D, 2 patients. Treatment modalities included the following: definitive RT, 5 patients; preoperative RT, 2 patients; and postoperative RT after resection, 19 patients. Elective neck irradiation (ENI) was performed in 17 (71%) of 24 N0 patients.
Rates of local control, cause-specific survival, and absolute overall survival at 5 years were 79%, 72%, and 69%, respectively. Overall survival among patients treated with definitive RT was 20% at 5 years, compared with 81% among those who underwent surgery and adjuvant RT (P=0.01). One (6%) of 17 patients who received ENI developed a recurrence in the neck and was successfully salvaged. Ultimate neck control was 100% at 5 years for patients who received ENI versus 69% among those not receiving ENI (P=0.0173).
Resection combined with adjuvant RT is more effective than surgery or RT alone in the treatment of esthesioneuroblastoma. ENI reduces the risk of regional relapse in patients with Kadish stage B and C cancers.
嗅神经母细胞瘤是鼻腔的一种罕见癌症。我们描述了在佛罗里达大学接受根治性光子放疗（RT）的26例患者的治疗结果。
1972年5月至2007年6月期间，26例患者因鼻腔初治嗅神经母细胞瘤接受放疗。16例为男性，10例为女性，中位年龄55岁（范围3至82岁）。改良Kadish分期分布为：B期7例；C期17例；D期2例。治疗方式包括：根治性放疗5例；术前放疗2例；切除术后放疗19例。24例N0患者中有17例（71%）接受了选择性颈部照射（ENI）。
5年时的局部控制率、病因特异性生存率和绝对总生存率分别为79%、72%和69%。接受根治性放疗的患者5年总生存率为20%，而接受手术及辅助放疗的患者为81%（P = 0.01）。17例接受ENI的患者中有1例（6%）颈部复发并成功挽救。接受ENI的患者5年颈部最终控制率为100%，未接受ENI的患者为69%（P = 0.0173）。
在嗅神经母细胞瘤的治疗中，手术联合辅助放疗比单纯手术或放疗更有效。ENI可降低Kadish B期和C期癌症患者区域复发的风险。
