title: Esthesioneuroblastoma with large intracranial extension treated with Induction chemotherapy, de-bulking surgery and image guided intensity modulated radiotherapy.
abstract: BACKGROUND
  Esthesioneuroblastoma is a rare tumour of the sino-nasal tract. One-third cases present with intracranial extension. However, treatment options are limited for such cases.
  
  
  METHODS
  We herein report a case with large intracranial extension treated with Induction chemotherapy, de-bulking surgery, and image guided intensity modulated radiotherapy.
  
  
  RESULTS
  The patient was treated with IGIMRT technique to a dose of 64 Gy in 32 fractions. Cone bean CT verification was done twice a week to eliminate set up error. The patient achieved complete resolution of the disease and was disease free 6 months after completion of treatment.
  
  
  CONCLUSIONS
  IGIMRT even after a de-bulking surgery may help to achieve long-term disease control for patients with large intracranial extension with minimal morbidity.
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Giridhar
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. drsupriyamallick@gmail.com.
authors.forename: Supriya
authors.initials: S
authors.lastname: Mallick
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: M A
authors.initials: MA
authors.lastname: Laviraj
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Bhasker
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D004210:Dissection / Q000379:methods; D018304:Esthesioneuroblastoma, Olfactory / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D008297:Male; D009296:Nasal Cavity / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D009669:Nose Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016896:Treatment Outcome
keywords: Conformal; Esthesioneuroblastoma; IGIMRT; Intracranial; Radiotherapy