Proton therapy for pediatric and adolescent esthesioneuroblastoma

John T. Lucas, Matthew Ladra, Shannon M. Macdonald, Paul M. Busse, Alison M. Friedmann, David H. Ebb, Karen J. Marcus, Nancy J. Tarbell, Torunn I. Yock

Research output: Contribution to journalArticle

Abstract

Esthesioneuroblastoma (EN) of the paranasal sinus comprises less than 3% of tumors of in pediatric and adolescent patients [1]. The collective adult literature indicates a critical role for radiotherapy in attaining cure [2], yet pediatric outcome data is limited. Radiation in pediatric patients with EN can cause significant morbidity due to the proximity of critical structures. Proton radiotherapy offers a potential dosimetric benefit that may improve long-term survival and toxicity outcomes in the pediatric population [3]. Methods: We retrospectively identified eight patients treated for EN with proton radiotherapy from 2000-2013. Times to event clinical endpoints are summarized using the Kaplan-Meier methods and are from the date of radiotherapy completion. Toxicities are reviewed and graded according to CTCAE v. 4.0. Results: Median follow up was 4.6 years for survivors (range 0.8-9.4 years). The 4 year overall survival was 87.5%. Four of eight patients (one elective) had comprehensive neck radiotherapy. No local or regional failures were observed. Two patients failed distantly with diffuse leptomeningeal disease and intraparenchymal brain metastases, at 0.6 and 1.3 months respectively. Four patients developed radiation related late toxicities including endocrine dysfunction, two cases of grade 2 retinopathy and one case of grade 3 optic neuropathy. Conclusions: In a limited cohort, proton radiotherapy appears to provide excellent locoregional disease control even in those patients with locally advanced disease and intracranial extension. Distant failure determined overall survival in our cohort. Toxicities were acceptable given disease location and extent.

Original languageEnglish (US)
Pages (from-to)1523-1528
Number of pages6
JournalPediatric Blood and Cancer
Volume62
Issue number9
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Fingerprint

Olfactory Esthesioneuroblastoma
Proton Therapy
Pediatrics
Radiotherapy
Protons
Survival
Radiation
Optic Nerve Diseases
Paranasal Sinuses
Brain Diseases
Survivors
Neck
Neoplasm Metastasis
Morbidity

Keywords

  • Esthesioneuroblastoma
  • Olfactory neuroblastoma
  • Proton radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Medicine(all)

Cite this

Lucas, J. T., Ladra, M., Macdonald, S. M., Busse, P. M., Friedmann, A. M., Ebb, D. H., ... Yock, T. I. (2015). Proton therapy for pediatric and adolescent esthesioneuroblastoma. Pediatric Blood and Cancer, 62(9), 1523-1528. https://doi.org/10.1002/pbc.25494

Proton therapy for pediatric and adolescent esthesioneuroblastoma. / Lucas, John T.; Ladra, Matthew; Macdonald, Shannon M.; Busse, Paul M.; Friedmann, Alison M.; Ebb, David H.; Marcus, Karen J.; Tarbell, Nancy J.; Yock, Torunn I.

In: Pediatric Blood and Cancer, Vol. 62, No. 9, 01.09.2015, p. 1523-1528.

Research output: Contribution to journalArticle

Lucas, JT, Ladra, M, Macdonald, SM, Busse, PM, Friedmann, AM, Ebb, DH, Marcus, KJ, Tarbell, NJ & Yock, TI 2015, 'Proton therapy for pediatric and adolescent esthesioneuroblastoma', Pediatric Blood and Cancer, vol. 62, no. 9, pp. 1523-1528. https://doi.org/10.1002/pbc.25494
Lucas JT, Ladra M, Macdonald SM, Busse PM, Friedmann AM, Ebb DH et al. Proton therapy for pediatric and adolescent esthesioneuroblastoma. Pediatric Blood and Cancer. 2015 Sep 1;62(9):1523-1528. https://doi.org/10.1002/pbc.25494
Lucas, John T. ; Ladra, Matthew ; Macdonald, Shannon M. ; Busse, Paul M. ; Friedmann, Alison M. ; Ebb, David H. ; Marcus, Karen J. ; Tarbell, Nancy J. ; Yock, Torunn I. / Proton therapy for pediatric and adolescent esthesioneuroblastoma. In: Pediatric Blood and Cancer. 2015 ; Vol. 62, No. 9. pp. 1523-1528.
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