Radiotherapy of esthesioneuroblastoma

Purpose: Only 3% of all malignant intranasal tumors are esthesioneuroblasto mas (ENB). As the tumor is very rare, the number of ENB treated in individu al departments is small. In order to evaluate the efficacy of radiotherapy (RT), patients' data of 2 centres were analysed with reference to new repor ts in literature. Methods and Materials: From 1981 to 1998, 17 patients with ENB, 8 men and 9 women aged between 6 and 81 years, were treated in the departments of radi otherapy of the universities of Cologne and Muenster. The tumors were Kadis h Stage B in 4/17 patients and Stage C in 13/17 patients. Treatment include d incomplete surgery and irradiation in 2/17 patients, adjuvant RT postoper atively in 6/17 patients, definitive RT in 7/17 patients and RT after incom plete surgery of recurrent tumors in 2/17 patients. Postoperatively, the me dian target dose of EBRT was 56 (range 50-60) Gy; for definitive RT it was 58 (range 30-70) Gy. Results: After a median follow-up period of 86 (range 2-208) months 10/17 p atients showed no evidence of disease (NED). There were 6 patients treated with radical complete surgery plus postoperative irradiation and 5 of them were NED. There were 7 patients treated with only irradiation and 3 of thos e patients were NED. Of 2 patients with incomplete surgery and irradiation there was one patient NED. Of 2 patients with incomplete resection of recur rent tumor who received irradiation, there was one patient NED. 2 of the pa tients with NED died after 22 and 94 months respectively. 4/17 patients die d as a result of local recurrence and 2/17 patients as a result of distant metastases (liver, brain). One patient with a recurrent tumor is alive. Med ian survival of all 17 patients was 94 months. Progressive disease after de finitive RT occurred after a median of 11 months. Conclusions: Esthesioneuroblastomas are radiocurable tumors. In correlation to literature a primarily complete tumor resection followed by adjuvant RT (50-60 Gy) offers the best disease free survival. (C) 2001 Elsevier Scienc e Inc.