Abstract
Background Consensus in timing of radiotherapy is yet to be established in esthesioneuroblastoma
(ENB).
Objective This study was aimed to investigate if planned adjuvant radiotherapy improves tumor
control after complete margin negative resection of low Hyams' grade (1 or 2) ENB.
Methods A retrospective review of patients with pathologically confirmed negative margin
resection of Kadish's stage B or C and Hyams' grade 1 and 2 ENBs was conducted. Seventeen
patients meeting the criteria were divided into the following two groups for cohort
study: (1) those who underwent planned immediate postoperative adjuvant radiotherapy
(IR group) and (2) those who did not (delayed radiotherapy [DR] group).
Results The IR group included nine patients (Kadish's stage B in one and stage C in eight;
Hyams' grade 1 in two and grade 2 in seven). Mean follow-up was 140.8 months. Seven
patients (78%) had disease progression (DP) at a median of 88 months (four with cervical
lymph node metastasis [CLNM], one with distant metastasis, and two with both local
recurrence and CLNM). One patient experienced frontal lobe abscess. The DR group included
eight patients (Kadish's stage B in six and stage C in two; all Hyams' grade 2). Mean
follow-up was 123.3 months. Four (50%) patients who developed DP (all local recurrence)
were salvaged with surgery and adjuvant radiotherapy at a median of 37.5 months. There
was no statistically significant difference in DP rate (p = 0.23), time to DP (p = 0.26), or the local tumor control rate (p = 0.23).
Conclusion In our limited cohort, immediate postoperative radiotherapy did not demonstrate superiority
in tumor control, although risk of radiotherapy toxicity appears low.
Keywords
craniofacial resection - esthesioneuroblastoma - intensity-modulated radiation therapy
- olfactory neuroblastoma - surgical treatment
