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Management of orbital invasion in esthesioneuroblastoma: 14 years' experience

Li, Ruichen ; Tian, Shu ; Zhu, Yi ; Yan, Li ; Zhu, Wenjia ; Quan, Huatao ; Wang, Shengzi

Radiation oncology (London, England), 2019-06, Vol.14 (1), p.107-12, Article 107 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
Management of orbital invasion in esthesioneuroblastoma: 14 years' experience
Autor: Li, Ruichen ; Tian, Shu ; Zhu, Yi ; Yan, Li ; Zhu, Wenjia ; Quan, Huatao ; Wang, Shengzi
Assuntos: Adult ; Aged ; Analysis ; Cancer metastasis ; Cancer therapies ; Chemotherapy ; Combined Modality Therapy ; Diagnosis ; Elective Surgical Procedures - methods ; Endoscopy ; Esthesioneuroblastoma ; Esthesioneuroblastoma, Olfactory - pathology ; Esthesioneuroblastoma, Olfactory - therapy ; Family medical history ; Female ; Head & neck cancer ; Humans ; Irradiation ; Male ; Medical imaging ; Medical prognosis ; Metastases ; Middle Aged ; Multivariate analysis ; Muscles ; Nasal Cavity - radiation effects ; Nasal Cavity - surgery ; Neck ; Neoplasm Invasiveness ; Neuroblastoma ; Nose Neoplasms - pathology ; Nose Neoplasms - therapy ; Oculomotor system ; Olfactory epithelium ; Orbital invasion ; Orbital Neoplasms - pathology ; Orbital Neoplasms - therapy ; Orbital preservation ; Organs at Risk - radiation effects ; Outcome and process assessment (Medical care) ; Patients ; Planning ; Preservation ; Prognosis ; Prognostic factors ; Quality ; Radiation ; Radiation (Physics) ; Radiation therapy ; Radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Intensity-Modulated - methods ; Retrospective Studies ; Risk factors ; Statistical analysis ; Strategic planning (Business) ; Surgery ; Survival ; Survival Rate ; Tumors ; Young Adult
É parte de: Radiation oncology (London, England), 2019-06, Vol.14 (1), p.107-12, Article 107
Descrição: There is a scarcity of data about the prognostic value of orbital invasion in esthesioneuroblastoma (ENB), as well as about its management strategies. Indications for the preservation of orbital contents remain controversial, and the evaluation of orbital invasion has been ill defined. This retrospective analysis contained 60 ENB patients with orbital invasion who underwent radiotherapy with or without surgery over the past 14 years. Orbital invasion was classified into three grades. There were 52 patients at stage C and 8 at stage D, according to Foote classifications. Grade I, grade II and grade III orbital invasion was detected in 12, 23, and 25 patients, respectively. The median follow-up was 57 months (IQR 32-95 months). Fourteen patients received radical radiotherapy, with a 5-year overall survival (OS) of 63.5%; 46 received surgery plus radiation, with a 5-year OS of 70.7%; and the difference was not statistically significant (p = 0.847). Orbital preservation was feasible in 100% of cases, including 18 cases that extended to extraocular muscles or the eye globe. Five-year locoregional relapse-free survival was 100% in patients with prophylactic elective neck irradiation (PENI) and 58.1% in patients without PENI (p = 0.004). Univariate analysis showed that grade II/III orbital invasion was associated with poorer OS and progression-free survival. Neck metastasis (with a Foote stage of D) was independently associated with shorter OS and distant metastasis-free survival in multivariate analysis. Our data suggested that primary radiotherapy achieved comparable survival to surgery plus radiotherapy in advanced ENB. Invasion of either the extraocular muscles or the eye globe is not a contraindication for eye-sparing surgery. Orbital invasion in grade II/III was significantly associated with adverse survival outcomes. Prophylactic radiotherapy to the neck with N0 significantly reduces the risk of regional recurrence.
Editor: England: BioMed Central Ltd
Idioma: Inglês

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Management of orbital invasion in esthesioneuroblastoma: 14 years' experience

Li, Ruichen ; Tian, Shu ; Zhu, Yi ; Yan, Li ; Zhu, Wenjia ; Quan, Huatao ; Wang, Shengzi

England: BioMed Central Ltd

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