You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Stereotactic Radiosurgical Salvage Treatment for Locally Recurrent Esthesioneuroblastoma

Van Gompel, Jamie J. MD*; Carlson, Matthew L. MD; Pollock, Bruce E. MD*; Moore, Eric J. MD; Foote, Robert L. MD§; Link, Michael J. MD*,‡

Neurosurgery:
doi: 10.1227/NEU.0b013e31827fcdc2
Research-Human-Clinical Studies
Abstract

BACKGROUND: Esthesioneuroblastoma (ENB) is a rare malignant neuroendocrine tumor considered to be radiation sensitive. Local recurrence may be treated in a variety of ways, including stereotactic radiosurgery (SRS); however, little information on its effectiveness is available.

OBJECTIVE: To determine whether SRS is effective in providing local control for recurrent ENB.

METHODS: This was a retrospective single-institution experience including 109 patients with ENB treated at the Mayo Clinic (1962-2009). Sixty-three patients presented with Kadish stage C disease, and 21 patients developed local recurrence. Of these 21 patients, 7 patients underwent SRS at our institution and an additional patient underwent SRS after transnasal biopsy. Therefore, a total of 8 patients are reported.

RESULTS: The median age at time of local recurrence was 50 years. All patients had Kadish C disease at initial diagnosis. Six of 8 patients were found to have Hyams grade 3 disease; the remaining 2 patients had grade 2 disease. The median treatment volume was 8.4 cm3 (mean, 18.9 cm3; range, 1.4-76.3 cm3), and the median dose to the tumor margin was 15 Gy (mean, 14.4 ± 2.2 Gy; range, 10-18 Gy). Of the 16 treatments, 13 had adequate follow-up to assess treatment response, with 92% achieving local control over a median follow-up of 42 months from the time of SRS. Five lesions decreased in size, 7 lesions stabilized, and only 1 lesion had in-field progression. There were no documented complications secondary to SRS.

CONCLUSION: SRS appears to be a reasonable and safe option for treatment of intracranial recurrence of ENB.

ABBREVIATIONS: EBRT, external beam radiotherapy

ENB, esthesioneuroblastoma

SRS, stereotactic radiosurgery

Author Information

Departments of *Neurosurgery

Otorhinolaryngology

§Radiation Oncology, Mayo Clinic, Rochester, Minnesota

Correspondence: Jamie J. Van Gompel, MD, Department of Neurosurgery, Mayo Clinic, 200 First St, SW, Rochester, MN 55905. E-mail: vangompel.jamie@mayo.edu

Reprint Requests: Michael J. Link MD, Department of Neurosurgery, Mayo Clinic, 200 First St, SW, Rochester, MN 55905. E-mail: link.michael@mayo.edu

Received July 15, 2012

Accepted November 07, 2012

Copyright © by the Congress of Neurological Surgeons