Role of induction chemotherapy in advanced-stage olfactory neuroblastoma

IF 7.2 2区医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-08-20 DOI:10.1002/alr.23428

Sung-Woo Cho MD, PhD, Bhumsuk Keam MD, PhD, Keun-Wook Lee MD, PhD, Ji-Won Kim MD, PhD, Doo Hee Han MD, PhD, Hyun Jik Kim MD, PhD, Jeong-Whun Kim MD, PhD, Dong-Young Kim MD, PhD, Chae-Seo Rhee MD, PhD, Yun Jung Bae MD, PhD, Ji-Hoon Kim MD, PhD, Keun-Yong Eom MD, PhD, Hong-Gyun Wu MD, PhD, Yong Hwy Kim MD, PhD, Chae-Yong Kim MD, PhD, Sun Ha Paek MD, PhD, Hyojin Kim MD, PhD, Tae-Bin Won MD, PhD

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Abstract

Objectives

To evaluate the treatment outcomes in patients with advanced-stage olfactory neuroblastoma (ONB) who received induction chemotherapy (IC).

Materials and methods

The clinical data of 38 patients with advanced-stage ONB who received initial IC were retrospectively analyzed. The response was defined using the Response Evaluation Criteria in Solid Tumors version 1.1. Patients with complete remission or partial remission were defined as responders.

Results

Seventeen (44.7%) patients responded to IC. The response rate was higher in patients with high Hyams grade tumor (III/IV) compared to those with low-grade tumors (I/II) (60% vs. 22.2%, p = 0.038). Overall, the 5-year cancer-specific survival (CSS) rate was 76.0%. Among nonresponders to IC, a significant difference in 5-year CSS rates was observed between surgery with adjuvant radiotherapy (RT) (100%) versus definitive RT or chemoradiotherapy (CRT) (68.6%) (log-rank p = 0.006). However, for responders, there was no significant difference in 5-year CSS rates between surgery with adjuvant therapy (75%) and definitive RT or CRT (51.1%) (log-rank p = 0.536). When only high-grade tumors were considered among responders, the 5-year CSS rate was significantly higher in patients who received RT or CRT (51.4%) compared to those who underwent surgery with adjuvant therapy (0%) (log-rank p = 0.008).

Conclusion

In advanced-stage ONB, RT or CRT may be preferable for high-grade tumor responding to IC. Higher response rate and a potential role for induction IC in determining the optimal definitive treatment modality suggest a positive role for advanced-stage high-grade ONB.

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诱导化疗在晚期嗅神经母细胞瘤中的作用。

摘要评估接受诱导化疗（IC）的晚期嗅神经母细胞瘤（ONB）患者的治疗效果：回顾性分析38例接受初始诱导化疗的晚期嗅神经母细胞瘤患者的临床数据。反应采用实体瘤反应评估标准 1.1 版进行定义。完全缓解或部分缓解的患者被定义为应答者：结果：17 名患者（44.7%）对 IC 有反应。与低分级肿瘤（I/II）患者相比，高Hyams分级肿瘤（III/IV）患者的应答率更高（60% vs. 22.2%，p = 0.038）。总体而言，5年癌症特异性生存率（CSS）为76.0%。在对 IC 无应答者中，手术加辅助放疗（RT）（100%）与最终 RT 或化学放疗（CRT）（68.6%）的 5 年 CSS 率存在显著差异（log-rank p = 0.006）。然而，就有反应者而言，手术加辅助治疗（75%）与明确RT或CRT（51.1%）的5年CSS率没有显著差异（log-rank p = 0.536）。如果只考虑有反应者中的高级别肿瘤，接受RT或CRT治疗的患者的5年CSS率（51.4%）明显高于接受手术辅助治疗的患者（0%）（log-rank p = 0.008）：结论：对于晚期ONB，RT或CRT可能是对IC有反应的高级别肿瘤的首选。较高的反应率和诱导 IC 在确定最佳最终治疗方式方面的潜在作用表明，它对晚期高级别 ONB 有积极作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Forum of Allergy & Rhinology OTORHINOLARYNGOLOGY-

CiteScore

11.70

自引率

10.90%

发文量

185

审稿时长

6-12 weeks

期刊介绍： International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.