Proton Beam Radiotherapy versus Intensity-Modulated Radiotherapy in Olfactory Neuroblastoma: A Multi-institutional Propensity-Matched Study
Notice bibliographique
Résumé
Introduction: Olfactory neuroblastoma (ONB) is a rare sinonasal malignancy that can present with locally advanced disease. Previous studies have demonstrated that post-resection radiotherapy can provide a survival and recurrence advantage in patients with ONB, particularly in the setting of higher stage and histologic grade. Two of the main methods of radiotherapy delivery include proton beam radiotherapy (PBRT) and intensity-modulated radiotherapy (IMRT). The differences in the effectiveness of these two methods have been studied in other fields including head and neck cancer; however, no studies comparing the two methods have been studied for patients with ONB. Therefore, the purpose of this study is to compare the differences in survival and recurrence for ONB patients being treated with PBRT and IMRT using propensity-matched cohorts from a multi-institutional database. Methods: This modern-era multicenter data originated from the retrospective review of electronic health records (EHRs) of all patients who presented with ONB between 2005 and 2021 at nine academic, tertiary care centers within North America. Only patients treated with either IMRT or PBRT were included in the study. Clinicopathologic features including treatment modalities, pathologic and MRI imaging status, modified Kadish staging systems, Hyams grading, margin status, and follow-up time. Outcomes collected for analysis included local recurrence-free survival (Local-RFS), regional recurrence-free survival (Regional-RFS), total recurrence-free survival (RFS), and overall surval (OS). Propensity matching of age, gender, Hyams grade, modified Kadish staging, resection margin status, and chemotherapy use ( Table 1 ) between treatment modalities was confirmed with chi-square and Fisher’s exact tests. Statistical analysis was done using Kaplan–Meier curves and log-rank tests. Results: Of the 205 ONB patients treated with surgical resection and adjuvant radiation therapy for curative intent, 18 patients were identified to receive PBRT. This cohort was then matched to the current standard of IMRT at a 1:1 ratio for a total of 36 patients in this multi-institutional study. The average follow-up time for IMRT was 71.7 (SD, 52.9) months and for PBRT was 53.2 (SD, 39.5) months ( p = 0.24). For IMRT, the 5-year local-RFS, Regional-RFS, RFS and 5-year OS were 69.2, 92.9, 64.8, and 80.8%, respectively. For PBRT, the 5-year local-RFS, Regional-RFS, RFS and 5-year OS were 90.9, 79.7, 56.7, and 85.7%, respectively. Similarly, there were no differences in local RFS ( p = 0.34, [ Fig. 1 ]), regional RFS ( p = 0.29, [ Fig. 2 ]), total recurrence-free survival ( p = 0.4, [ Fig. 3 ]), and overall survival ( p = 0.52, [ Fig. 4 ]) between patients treated with PBRT and IMRT. Fig. 1 Fig. 2 Fig. 3 Fig. 4 Conclusion: This study is the first to compare the effectiveness of IMRT and PBRT in patients with advanced olfactory neuroblastoma. These findings support that IMRT and PBRT are comparable in overall survival and recurrence-free survival as treatment methods for advanced stage/grade olfactory neuroblastoma. Future investigations comparing quality-of-life outcomes between these radiotherapy modalities are needed to better delineate patient-centered treatments for ONB. Publication History Article published online: 07 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».