Neoadjuvant chemotherapy in the treatment of locally advanced olfactory neuroblastoma in 25 cases.
10.3760/cma.j.cn115330-20230115-00026
- VernacularTitle:局部晚期嗅神经母细胞瘤新辅助化疗25例临床分析
- Author:
Yan SUN
1
;
Shu Rong ZHANG
2
;
Ming Jie WANG
1
;
Qian HUANG
1
;
Shun Jiu CUI
1
;
Ben Tao YANG
3
;
E QIU
4
;
Cheng LI
1
;
Bing ZHOU
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
2. Department of Oncology, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
3. Department of Radiology, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
4. Department of Neurosurgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
- Publication Type:Journal Article
- MeSH:
Male;
Female;
Humans;
Adult;
Middle Aged;
Aged;
Neoadjuvant Therapy/methods*;
Retrospective Studies;
Esthesioneuroblastoma, Olfactory/etiology*;
Ki-67 Antigen;
Paclitaxel;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Nasal Cavity;
Nose Neoplasms/therapy*;
Neoplasm Staging
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2023;58(5):425-430
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the efficacy of neoadjuvant chemotherapy (NACT) in the treatment of locally advanced olfactory neuroblastoma (ONB), and to explore the factors related to the efficacy of NACT. Methods: A total of 25 patients with ONB who underwent NACT in Beijing TongRen Hospital from April 2017 to July 2022 were retrospectively analyzed. There were 16 males and 9 females, with an average age of 44.9 years (ranged 26-72 years). There were 22 cases of Kadish stage C and 3 cases of stage D. After multiple disciplinary team(MDT) discussion, all patients were treated sequentially with NACT-surgery-radiotherapy. Among them, 17 cases were treated with taxol, cis-platinum and etoposide (TEP), 4 cases with taxol, nedaplatin and ifosfamide (TPI), 3 cases with TP, while 1 case with EP. SPSS 25.0 software was used for statistical analysis, and survival analyses were calculated based on the Kaplan-Meier method. Results: The overall response rate of NACT was 32% (8/25). Subsequently, 21 patients underwent extended endoscopic surgery and 4 patients underwent combined cranial-nasal approach. Three patients with stage D disease underwent cervical lymph node dissection. All patients received postoperative radiotherapy. The mean follow-up time was 44.2 months (ranged 6-67 months). The 5-year overall survival rate was 100.0%, and the 5-year disease-free survival rates was 94.4%. Before NACT, Ki-67 index was 60% (50%, 90%), while Ki-67 index was 20% (3%, 30%) after chemotherapy [M (Q1, Q3)]. The change of Ki-67 before and after NACT was statistically significant (Z=-24.24, P<0.05). The effects of age, gender, history of surgery, Hyams grade, Ki-67 index and chemotherapy regimen to NACT were analyzed. Ki-67 index≥25% and high Hyams grade were related to the efficacy of NACT (all P<0.05). Conclusions: NACT could reduce Ki-67 index in ONBs. High Ki-67 index and Hyams grade are clinical indicators sensitive to the efficacy of NACT. NACT-surgery-radiotherapy is effective for patients with locally advanced ONB.
