(P084) Long-Term Functional and Oncologic Outcomes of Esthesioneuroblastoma

OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

ENB is a rare malignancy, with optimal management remaining uncertain. Our experience suggests that aggressive management seems successful in providing sustained LRC with acceptable long-term toxicity. The role of elective nodal irradiation to the upper neck remains unclear.

David Zaenger, MD, Bryan M. Rabatic, PhD, MD, Joseph M. Kaminski, MD, Waleed F. Mourad, MD, PhD; Georgia Regents University

PURPOSE: We report our multimodality functional and oncologic outcomes in the management of esthesioneuroblastoma (ENB).

MATERIALS: This is a single-institution retrospective study of 22 patients treated between 1998 and 2014 for ENB. The median age was 47 years (range: 29–68 yr); 13 patients (59%) were male. The percentages of patients in Kadish stages A, B, and C were 45%, 32%, and 23%, respectively. Two patients (9%) received definitive induction chemotherapy, followed by chemoradiation therapy (CRT) (70 Gy), and 20 patients (91%) received postoperative RT (PORT) to a median dose of 59.4 Gy (range: 54–63 Gy). Intensity-modulated radiation therapy (IMRT) was utilized in 64% of the whole cohort. PORT fields included the preoperative tumor bed and elective bilateral upper neck lymph node (LN) levels IB and II.

RESULTS: The median follow-up for the whole cohort was 40 months (range: 12–150 mo). The actuarial 4-year disease-free survival (DFS) was 68%. The 4-year actuarial overall survival (OS) was 86%. The 4-year actuarial locoregional control (LRC) was 68%, and distant control (DC) was 95%. Of the seven failures, two developed infield local failure and underwent successful salvage surgery and SRS boost, three patients failed locoregionally (primary site and neck), one failed regionally (neck alone), and one developed simultaneous local and distant failure. Recurrences manifested as late as 112 months. No adverse events related to vision were reported. A total of 10% developed short-term grade 3 dysphagia, without long-term percutaneous endoscopic gastrostomy (PEG) tube dependency.

CONCLUSIONS: ENB is a rare malignancy, with optimal management remaining uncertain. Our experience suggests that aggressive management seems successful in providing sustained LRC with acceptable long-term toxicity. The role of elective nodal irradiation to the upper neck remains unclear.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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