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This study compared intensity-modulated radiotherapy (IMRT) and proton beam radiotherapy (PBRT) for olfactory neuroblastoma (ONB). Preliminary results show no definitive differences in effectiveness or adverse events, warranting further research.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Adjuvant radiotherapy improves outcomes in olfactory neuroblastoma (ONB), especially for advanced disease.
  • Intensity-modulated radiotherapy (IMRT) is the standard treatment.
  • Proton beam radiotherapy (PBRT) offers theoretical advantages in sparing healthy tissues.

Purpose of the Study:

  • To compare the effectiveness of adjuvant IMRT versus PBRT in patients with ONB.
  • To evaluate differences in radiation treatment-related adverse events (RTAEs) between IMRT and PBRT.

Main Methods:

  • A propensity score-matched cohort study included 54 ONB patients treated between 2005 and 2021.
  • Patients received either IMRT or PBRT at 9 North American academic centers.
  • Outcomes included recurrence-free survival (RFS), any RFS, overall survival (OS), and RTAEs (grade ≥2).

Main Results:

  • The RTAE rate was 20% (IMRT 21%, PBRT 18%).
  • 10-year RFS estimates favored IMRT (63.3%) over PBRT (37.8%), but with wide confidence intervals indicating uncertainty.
  • No significant differences were observed in local RFS or OS between the two modalities, also with wide confidence intervals.

Conclusions:

  • Due to imprecise estimates, definitive conclusions on IMRT vs. PBRT effectiveness in ONB cannot be drawn.
  • These preliminary findings suggest the need for larger, prospective studies to evaluate PBRT efficacy compared to IMRT.
  • Further research is essential to guide optimal radiotherapy choices for ONB patients.