一项关于立体定向放射治疗嗅神经母细胞瘤硬脑膜复发管理的前瞻性队列研究。
A prospective cohort study on stereotactic radiotherapy in the management of dural recurrence of olfactory neuroblastoma.
作者信息
Goodman Christopher D, DeMonte Franco, Nguyen Theresa P, Garden Adam S, Wang Catherine He, Wang Xin A, Diao Kevin, Lee Anna, Reddy Jay, Moreno Amy, Spiotto Michael, Fuller Clifton D, Rosenthal David, Ferrarotto Renata, Raza Shaan M, Su Shirley Y, Warner Andrew, Hanna Ehab, Phan Jack
机构信息
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
出版信息
Head Neck. 2025 Jan;47(1):81-89. doi: 10.1002/hed.27887. Epub 2024 Jul 29.
BACKGROUND
Treatment for dural recurrence of olfactory neuroblastoma (ONB) is not standardized. We assess the outcomes of stereotactic body radiotherapy (SBRT) in this population.
METHODS
ONB patients with dural recurrences treated between 2013 and 2022 on a prospective registry were included. Tumor control, survival, and patient-reported quality of life were analyzed.
RESULTS
Fourteen patients with 32 dural lesions were evaluated. Time to dural recurrence was 58.3 months. Thirty lesions (94%) were treated with SBRT to a median dose of 27 Gy in three fractions. Two patients (3 of 32 lesions; 9%) developed in-field radiographic progression, five patients (38%) experienced progression in non-contiguous dura. Two-year local control was 85% (95% CI: 51-96%). There were no >grade 3 acute toxicities and 1 case of late grade 3 brain radionecrosis.
CONCLUSION
In this largest study of SBRT reirradiation for ONB dural recurrence to date, high local control rates with minimal toxicity were attainable.
背景
嗅神经母细胞瘤（ONB）硬脑膜复发的治疗尚无标准化方案。我们评估了立体定向体部放疗（SBRT）在该人群中的治疗效果。
方法
纳入2013年至2022年间在一项前瞻性登记研究中接受治疗的硬脑膜复发ONB患者。分析肿瘤控制情况、生存率以及患者报告的生活质量。
结果
评估了14例患者的32处硬脑膜病变。硬脑膜复发时间为58.3个月。30处病变（94%）接受了SBRT治疗，中位剂量为27 Gy，分3次给予。2例患者（32处病变中的3处；9%）出现野内影像学进展，5例患者（38%）在非连续硬脑膜处出现进展。两年局部控制率为85%（95%CI：51-96%）。无3级以上急性毒性反应，有1例3级晚期脑放射性坏死。
结论
在迄今为止关于SBRT再程放疗治疗ONB硬脑膜复发的最大规模研究中，可实现高局部控制率且毒性极小。
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