The Use of Induction Chemotherapy in Olfactory Neuroblastoma: A Multi-institutional Series
Notice bibliographique
Résumé
Introduction: Olfactory neuroblastoma (ONB) is a rare neuroectodermal tumor thought to originate from olfactory receptor cells of the nasal cavity. Negative-margin surgical resection may not be achievable in a subset of patients with locally advanced disease. Previous studies have shown that ONB is chemosensitive; further investigation is needed to explore the efficacy of induction chemotherapy (IC) to reduce tumor size and burden prior to definitive surgery. We present a modern-era multicenter ONB series of patients with locally advanced disease treated with IC. Methods: A modern-era multicenter retrospective review of patients with ONB at 9 academic, tertiary-care centers within North America from 2005 to 2021 was performed. Only patients who were treated with induction chemotherapy were included in the study. Clinicopathologic features including histopathologic and imaging status, modified Kadish staging and Hyams grading systems, treatment modalities, margin status, follow-up time, and survival were collected for analysis. Results: Fifteen patients with ONB were treated with induction chemotherapy. The patient population was predominantly male (60%) with a median age of 51 (IQR, 40.5–64) years. Regarding baseline tumor characteristics in patients with available MRI, 72.7% patients had dural invasion, 16.7% had cavernous sinus invasion, 30.8% had periorbital involvement, and 16.7% had intraconal orbital tissue involvement. Of the 14 patients with modified Kadish staging, 7 (50%) patients were stage C and 7 (50%) patients were stage D prior to treatment. Two (22.2%) patients were Hyams grade I, 3 (33.3%) patients were Hyams grade II, 1 (11.1%) patient was Hyams grade III, and 3 (33.3%) patients were Hyams grade IV. Two (13.3%) patients were treated with induction chemotherapy followed by chemo/radiotherapy and 13 (86.7%) patients with induction chemotherapy followed by resection and adjuvant chemo/radiotherapy. Nine patients had pathological data available following resection, including 5 (55.6%) patients with negative margins and 4 (44.4%) patients with positive margins. Of the four patients with positive margins, all four had adjuvant RT with intensity-modulated radiation therapy. The median follow-up period of the cohort was 46 (IQR, 19.1–130.6) months after diagnosis. Of 14 patients with sufficient data for analysis, 3 (21.4%) patients developed local disease recurrence after a median of 52.0 (IQR, 29.2–99.2) months. Three patients developed regional disease recurrence after 59.7 (IQR, 39–93.95) months. One patient with modified Kadish stage D ONB had both local and distant recurrence at 6.5 months. Overall, 6 patients experienced recurrence after a median of 52 (IQR, 29.2–99.2) months. Of the six patients who had recurrence after IC, two patients had prior neck radiation before recurrence. Both of these patients had local recurrence only. The 5-year recurrence-free survival and overall survival were 59.7 and 70.6%, respectively. Conclusion: Patients with ONB treated with IC tended to have more advanced disease at the time of treatment. Advanced-stage ONB tends to have lower rates of recurrence-free survival and overall survival. IC provides an additional treatment modality that has the potential to improve prognosis for patients with advanced-stage disease. Future large multi-institutional matched cohort studies are needed to delineate the role of IC in the management of this rare disease. 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 | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 ».