The value of elective neck irradiation in management of esthesioneuroblastoma: a retrospective study based on propensity score matching.


Journal

Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111

Informations de publication

Date de publication:
21 Oct 2024
Historique:
received: 27 05 2024
accepted: 13 10 2024
medline: 22 10 2024
pubmed: 22 10 2024
entrez: 21 10 2024
Statut: epublish

Résumé

This study aims to assess the clinical efficacy of elective neck irradiation (ENI) in patients with esthesineuroblastoma (ENB), a rare malignant neoplasm, who are clinically node-negative. We conducted a retrospective analysis of 178 patients newly diagnosed with ENB at our institution between 2009 and 2021. Propensity score matching (PSM) was employed to compare node-negative patients treated with and without ENI. We extensively examined survival outcomes and treatment failure. Of the 178 participants, 149 (83.7%) were lymph node-negative and staged in Modified Kadish A-C. 96 patients underwent ENI treatment, while 53 did not. At baseline, patients who received ENI differed from those who did not in terms of radiotherapy technique, staging, orbital invasion, surgical mode, and chemotherapy. After PSM, 43 pairs were available for analysis. ENI was observed to extend overall survival (OS, 5-year 73.9% vs. 84.0%; 3-year 76.9% vs. 97.1%, p = 0.022), progression-free survival (PFS, 5-year 38.5% vs. 84.6%; 3-year 50.5% vs. 94.5%, p < 0.001) and locoregional relapse-free survival (LRFS, 5-year 42.7% vs. 84.6%, p = 0.023; 3-year 57.3% vs. 94.5%, p < 0.001) in node-negative ENI patients. Failure pattern analyses revealed that ENI, which included level Ib, II, VIIa, significantly reduced the treatment failure rate. Furthermore, ENI did not significantly impact the prognosis of T1-2 patients, indicating potential clinical value of ENI in T3-4 patients. Our findings suggested that ENI decreased regional failure and significantly enhanced LRFS and PFS. ENI may be considered as an integral part of the initial treatment strategy for locally advanced node-negative ENB patients.

Sections du résumé

BACKGROUND BACKGROUND
This study aims to assess the clinical efficacy of elective neck irradiation (ENI) in patients with esthesineuroblastoma (ENB), a rare malignant neoplasm, who are clinically node-negative.
METHODS METHODS
We conducted a retrospective analysis of 178 patients newly diagnosed with ENB at our institution between 2009 and 2021. Propensity score matching (PSM) was employed to compare node-negative patients treated with and without ENI. We extensively examined survival outcomes and treatment failure.
RESULTS RESULTS
Of the 178 participants, 149 (83.7%) were lymph node-negative and staged in Modified Kadish A-C. 96 patients underwent ENI treatment, while 53 did not. At baseline, patients who received ENI differed from those who did not in terms of radiotherapy technique, staging, orbital invasion, surgical mode, and chemotherapy. After PSM, 43 pairs were available for analysis. ENI was observed to extend overall survival (OS, 5-year 73.9% vs. 84.0%; 3-year 76.9% vs. 97.1%, p = 0.022), progression-free survival (PFS, 5-year 38.5% vs. 84.6%; 3-year 50.5% vs. 94.5%, p < 0.001) and locoregional relapse-free survival (LRFS, 5-year 42.7% vs. 84.6%, p = 0.023; 3-year 57.3% vs. 94.5%, p < 0.001) in node-negative ENI patients. Failure pattern analyses revealed that ENI, which included level Ib, II, VIIa, significantly reduced the treatment failure rate. Furthermore, ENI did not significantly impact the prognosis of T1-2 patients, indicating potential clinical value of ENI in T3-4 patients.
CONCLUSIONS CONCLUSIONS
Our findings suggested that ENI decreased regional failure and significantly enhanced LRFS and PFS. ENI may be considered as an integral part of the initial treatment strategy for locally advanced node-negative ENB patients.

Identifiants

pubmed: 39434155
doi: 10.1186/s13014-024-02539-x
pii: 10.1186/s13014-024-02539-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

146

Subventions

Organisme : National Natural Science Foundation of China
ID : 82303420

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Yang Zhao (Y)

Department of Radiation Oncology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui, Shanghai, 200031, P.R. China.

Li Yan (L)

Department of Radiation Oncology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui, Shanghai, 200031, P.R. China.

Ruichen Li (R)

Department of Radiation Oncology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui, Shanghai, 200031, P.R. China.

Xiaoshen Wang (X)

Department of Radiation Oncology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui, Shanghai, 200031, P.R. China. xiaoshen.wang@fdeent.org.

Yi Zhu (Y)

Department of Radiation Oncology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Xuhui, Shanghai, 200031, P.R. China. zhuyi1113@hotmail.com.

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