title: Olfactory neuroblastoma: the long-term outcome and late toxicity of multimodal therapy including radiotherapy based on treatment planning using computed tomography.
abstract: BACKGROUND
  Olfactory neuroblastoma (ONB) is a rare tumor originating from olfactory epithelium. Here we retrospectively analyzed the long-term treatment outcomes and toxicity of radiotherapy for ONB patients for whom computed tomography (CT) and three-dimensional treatment planning was conducted to reappraise the role of radiotherapy in the light of recent advanced technology and chemotherapy.
  
  
  METHODS
  Seventeen patients with ONB treated between July 1992 and June 2013 were included. Three patients were Kadish stage B and 14 were stage C. All patients were treated with radiotherapy with or without surgery or chemotherapy. The radiation dose was distributed from 50 Gy to 66 Gy except for one patient who received 40 Gy preoperatively.
  
  
  RESULTS
  The median follow-up time was 95 months (range 8-173 months). The 5-year overall survival (OS) and relapse-free survival (RFS) rates were estimated at 88% and 74%, respectively. Five patients with stage C disease had recurrence with the median time to recurrence of 59 months (range 7-115 months). Late adverse events equal to or above Grade 2 in CTCAE v4.03 were observed in three patients.
  
  
  CONCLUSIONS
  Multimodal therapy including radiotherapy with precise treatment planning based on CT simulation achieved an excellent local control rate with acceptable toxicity and reasonable overall survival for patients with ONB.
authors.affiliation: Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan. tamori-tym@umin.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan. ronimaru@pop.med.hokudai.ac.jp.
authors.forename: Rikiya
authors.initials: R
authors.lastname: Onimaru
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan. m950086@jasmine.ocn.ne.jp.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onodera
authors.affiliation: Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan. tsuchi1205@gmail.com.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuchiya
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan. kyasuda@med.hokudai.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yasuda
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. htkym@med.hokudai.ac.jp.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hatakeyama
authors.affiliation: Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. hiro-ko@med.hokudai.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. terasas@med.hokudai.ac.jp.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Terasaka
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. ak-homma@med.hokudai.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan. shirato@med.hokudai.ac.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects*; D018304:Esthesioneuroblastoma, Olfactory / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011183:Postoperative Complications; D011379:Prognosis; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult