Liermann Jakob, Syed Mustafa, Held Thomas, Bernhardt Denise, Plinkert Peter, Jungk Christine, Unterberg Andreas, Rieken Stefan, Debus Jürgen, Herfarth Klaus, Adeberg Sebastian
Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.
Cancers (Basel). 2018 Nov 20;10(11):457. doi: 10.3390/cancers10110457.
(1) Background: Esthesioneuroblastoma (ENB) is a rare tumor entity originating from the olfactory neuroepithelium. There is a scarcity of data about different treatment strategies. Intensity modulated radiotherapy (IMRT) and carbon ion radiotherapy (CIRT) are advanced radiation techniques that might improve local tumor control. (2) Methods: This retrospective analysis contained 17 patients with ENB (Kadish stage ≥ C: 88%; = 15). Four patients had already undergone previous radiotherapy (RT). The treatment consisted of either IMRT ( = 5), CIRT ( = 4) or a combination of both techniques ( = 8). Median follow-up was 29 months. (3) Results: In patients that had not been irradiated before ( = 13), calculated overall survival (OS) and progression free survival (PFS) rates after 48 months were 100% and 81% respectively (Kaplan-Meier estimates). Two of four patients that underwent reirradiation died after RT, presumably due to tumor progression. Besides common toxicities, five patients (30%) showed mostly asymptomatic radiation-induced brain changes, most likely due to a disturbance of the blood-brain barrier. (4) Conclusions: Our results demonstrate that IMRT, CIRT, a combined approach of IMRT and CIRT as well as reirradiation with CIRT seem to be feasible and effective treatment methods in ENB.
(1) 背景：嗅神经母细胞瘤（ENB）是一种起源于嗅神经上皮的罕见肿瘤实体。关于不同治疗策略的数据匮乏。调强放射治疗（IMRT）和碳离子放射治疗（CIRT）是可能改善局部肿瘤控制的先进放射技术。(2) 方法：这项回顾性分析纳入了17例ENB患者（卡迪什分期≥C期：88%；n = 15）。4例患者之前已接受过放射治疗（RT）。治疗包括IMRT（n = 5）、CIRT（n = 4）或两种技术联合使用（n = 8）。中位随访时间为29个月。(3) 结果：在之前未接受过放疗的患者（n = 13）中，48个月时计算得出的总生存率（OS）和无进展生存率（PFS）分别为100%和81%（Kaplan-Meier估计值）。4例接受再放疗的患者中有2例在放疗后死亡，可能是由于肿瘤进展。除常见毒性外，5例患者（30%）主要表现为无症状的放射性脑改变，很可能是由于血脑屏障受到干扰。(4) 结论：我们的结果表明，IMRT、CIRT、IMRT与CIRT的联合方法以及CIRT再放疗似乎是ENB可行且有效的治疗方法。
