Multimodal treatment and long-term outcome of patients with esthesioneuroblastoma.
Détails
ID Serval
serval:BIB_B9074F682569
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Multimodal treatment and long-term outcome of patients with esthesioneuroblastoma.
Périodique
Oral oncology
ISSN
1879-0593 (Electronic)
ISSN-L
1368-8375
Statut éditorial
Publié
Date de publication
08/2013
Peer-reviewed
Oui
Volume
49
Numéro
8
Pages
830-834
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
To analyze the clinical features, treatment modalities and outcome of patients treated for a localized esthesioneuroblastoma (ENB).
Forty-three consecutive patients with biopsy proven ENB treated at two referral cancer centers between 1998 and 2010 were retrospectively reviewed.
Overall, 5 patients had stage A disease, 13 stage B, 16 stage C and 9 stage D according to the modified Kadish classification. Neo-adjuvant chemotherapy was performed in 23 patients leading to a 74 % response rate. Thirty-one patients were treated by surgery. Thirty-nine patients (90.6%) underwent radiation therapy. Twelve patients received bilateral cervical lymph node irradiation (LNI). After a median follow-up of 77 months, the 5-year overall and progression free survival were 65% and 57%. Twelve patients (28%) had a locoregional relapse leading to 10 ENB-related deaths. The major prognostic factor was the modified Kadish stage with a 3-year survival for stage A-B, C and D of 100%, 48% and 22% respectively (p < 0.0001). Two (9%) isolated cervical lymph node relapses occurred among staged B and C patients treated without elective LNI and none after elective or adjuvant LNI.
The high risk of locoregional failure in ENB justifies the use of multimodal therapy. Induction chemotherapy leads to a high response rate. Elective LNI might prevent regional failure in locally advanced disease.
Forty-three consecutive patients with biopsy proven ENB treated at two referral cancer centers between 1998 and 2010 were retrospectively reviewed.
Overall, 5 patients had stage A disease, 13 stage B, 16 stage C and 9 stage D according to the modified Kadish classification. Neo-adjuvant chemotherapy was performed in 23 patients leading to a 74 % response rate. Thirty-one patients were treated by surgery. Thirty-nine patients (90.6%) underwent radiation therapy. Twelve patients received bilateral cervical lymph node irradiation (LNI). After a median follow-up of 77 months, the 5-year overall and progression free survival were 65% and 57%. Twelve patients (28%) had a locoregional relapse leading to 10 ENB-related deaths. The major prognostic factor was the modified Kadish stage with a 3-year survival for stage A-B, C and D of 100%, 48% and 22% respectively (p < 0.0001). Two (9%) isolated cervical lymph node relapses occurred among staged B and C patients treated without elective LNI and none after elective or adjuvant LNI.
The high risk of locoregional failure in ENB justifies the use of multimodal therapy. Induction chemotherapy leads to a high response rate. Elective LNI might prevent regional failure in locally advanced disease.
Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Child, Esthesioneuroblastoma, Olfactory/diagnosis, Esthesioneuroblastoma, Olfactory/therapy, Female, Humans, Male, Middle Aged, Survival Analysis, Treatment Outcome, Young Adult, Concurrent chemotherapy, Elective neck irradiation, Esthesioneuroblastoma, Intensity Modulated Radiation Therapy, Neo-adjuvant chemotherapy, Olfactory neuroblastoma
Pubmed
Web of science
Création de la notice
16/10/2018 15:26
Dernière modification de la notice
20/08/2019 16:27