Hu Weixu, Hu Jiyi, Gao Jing, Yang Jing, Qiu Xianxin, Kong Lin, Lu Jiade J
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.
Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
Ann Transl Med. 2020 Aug;8(15):926. doi: 10.21037/atm-19-4790.
BACKGROUND: To report the clinical experience and short-term efficacy in the management of olfactory neuroblastoma (ONB). METHODS: We performed a retrospective analysis of 12 ONB patients treated with particle beam radiation therapy (PBRT) between 12/2015 and 5/2019 at the Shanghai Proton and Heavy Ion Center. Four (33.3%) patients presented with Kadish B ONB, and 8 (66.7%) presented with Kadish C or D disease. Eleven patients received proton radiotherapy (PRT) followed by a carbon ion radiotherapy (CIRT) boost, one patient received CIRT only. The 2-year survival rates were calculated using the Kaplan-Meier method. Acute and late adverse events were summarized and scored according to the CTCAE (version 4.03). RESULTS: With a median follow-up of 17.5 (range, 2.53-49.9) months, all patients but 1 were alive. Eight patients were alive without evidence of disease, and 2 additional patients achieved partial response and remained alive with residual disease. One patient died of toxicity associated with salvage chemotherapy for distant metastasis and local failure. Another patient developed distant metastasis only and was alive at the time of the last follow-up. The 2-year OS, PFS, LRPFS, and DMFS rates were 83.3%, 75.8%, 87.5%, and 79.5%, respectively. No acute or late toxicities of ≥ grade 3 was observed. CONCLUSIONS: Intensity modulated PBRT of ONB is well tolerated. While longer follow-up is needed, early outcomes suggested that PBRT is safe and effective for the treatment of ONB with minimal adverse events.
背景:报告嗅神经母细胞瘤(ONB)治疗的临床经验和短期疗效。 方法:我们对2015年12月至2019年5月期间在上海质子重离子中心接受粒子束放射治疗(PBRT)的12例ONB患者进行了回顾性分析。4例(33.3%)患者为Kadish B期ONB,8例(66.7%)为Kadish C期或D期疾病。11例患者接受质子放疗(PRT)后行碳离子放疗(CIRT)增敏,1例患者仅接受CIRT。采用Kaplan-Meier法计算2年生存率。根据CTCAE(第4.03版)总结并对急性和晚期不良事件进行评分。 结果:中位随访时间为17.5(范围2.53 - 49.9)个月,除1例患者外所有患者均存活。8例患者存活且无疾病证据,另外2例患者获得部分缓解并带瘤存活。1例患者死于远处转移和局部失败的挽救性化疗相关毒性。另1例患者仅发生远处转移,在最后一次随访时仍存活。2年总生存率(OS)、无进展生存率(PFS)、局部区域无进展生存率(LRPFS)和无远处转移生存率(DMFS)分别为83.3%、75.8%、87.5%和79.5%。未观察到≥3级的急性或晚期毒性反应。 结论:ONB的调强PBRT耐受性良好。虽然需要更长时间的随访,但早期结果表明PBRT治疗ONB安全有效,不良事件最少。
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