{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T20:41:23Z","timestamp":1767904883521,"version":"3.49.0"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec id=\"ab-obr250003-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Adjuvant radiotherapy can improve locoregional control and survival in patients with olfactory neuroblastoma (ONB), particularly with advanced-stage and histologic-grade disease. Standard radiotherapy treatment is with intensity-modulated radiotherapy (IMRT). Proton beam radiotherapy (PBRT) provides theoretical advantages in greater sparing of dose to uninvolved organs at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-obr250003-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate if there are differences in the effectiveness and radiation treatment\u2013related adverse events (RTAEs) between adjuvant IMRT and PBRT for patients with ONB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-obr250003-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This propensity score\u2013matched cohort study included patients with ONB treated between February 2005 and April 2021 with either IMRT or PBRT at 9 academic tertiary care centers in North America. Patients were matched 1:2 based on age, modified Kadish stage, and Hyams grade. Data were analyzed from July 2024 to January 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-obr250003-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Adjuvant IMRT or adjuvant PBRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-obr250003-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Local recurrence-free survival (RFS), any RFS, and overall survival (OS). RTAEs, ie, grade 2 events or higher based on Common Terminology Criteria for Adverse Events, were recorded for both modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-obr250003-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 54 included patients, 27 (50%) were female, and the mean (SD) age was 46.2 (15.4) years. A total of 18 were treated with PBRT and 36 were treated with IMRT. Most patients had modified Kadish stage C disease (33 of 54 [61%]), and 24 patients (44%) had Hyams grade III or IV disease. The RTAE rate was 20% (8 of 40); IMRT had a rate of 21% (6 of 29), and PBRT had a rate of 18% (2 of 11). The difference in the point estimates for 10-year RFS showed a potential clinical benefit favoring IMRT, although the wide confidence interval indicates uncertainty (10-year RFS: IMRT, 63.3%; 95% CI, 44.6-89.8; PBRT, 37.8%; 95% CI, 14.2-100; difference, 25.5 percentage points; 95% CI, \u221217.6 to 68.6). There were no clinically meaningful differences in 10-year local RFS (IMRT, 75.6%; 95% CI, 59.8-95.4; PBRT, 72.7%; 95% CI, 45.2-100; difference, 2.9 percentage points; 95% CI, \u221235.9 to 41.7) or 10-year OS (IMRT, 61.8%; 95% CI, 42.8-89.1; PBRT, 57.1%; 95% CI, 24.3-100; difference, 4.7 percentage points; 95% CI, \u221249.2 to 58.6), although wide confidence intervals indicate considerable uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-obr250003-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Due to the imprecision of estimates, no definitive conclusions can be made regarding the comparative effectiveness of IMRT vs PBRT for patients with ONB. These preliminary data may inform the design of appropriately powered prospective studies evaluating the efficacy of PBRT vs IMRT in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoto.2025.3816","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T15:31:37Z","timestamp":1761838297000},"page":"60","source":"Crossref","is-referenced-by-count":0,"title":["Proton Beam vs Intensity-Modulated Radiotherapy in Olfactory Neuroblastoma"],"prefix":"10.1001","volume":"152","author":[{"given":"Anthony","family":"Tang","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Adida","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, 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C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Stanford University, Palo Alto, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Stanford University, Palo Alto, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Stanford University, Palo Alto, 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Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios A.","family":"Zenonos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan T.","family":"Zwagerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Medical College of Wisconsin, Milwaukee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Wilke","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, 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