{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:33:37Z","timestamp":1777530817189,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric esthesioneuroblastoma (EN) can infiltrate skull base anatomy, presenting challenges due to high radiation doses and pediatric tissue sensitivity. This study reports outcomes of pediatric EN treated with proton radiotherapy (PT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Using an IRB\u2010approved prospective outcomes registry, we evaluated patient, tumor, and treatment\u2010related variables impacting disease control and toxicity in pediatric nonmetastatic EN treated with modern multimodality therapy, including PT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen consecutive patients (median age 16) comprising Kadish stage B (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), C (<jats:italic>n<\/jats:italic>\u00a0=\u00a09), and D (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) tumors were assessed, including six with intracranial involvement, four with cranial nerve deficits, and four with cervical lymphadenopathy. Before radiation, two had subtotal and 13 had gross total resections (endoscopic or craniofacial). Two underwent neck dissection. Eleven received chemotherapy before radiation (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), concurrent with radiation (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), or both (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). Median total radiation dose (primary site) was 66\u00a0Gy\/CGE for gross disease and 54\u00a0Gy\/CGE (cobalt Gray equivalent) for microscopic disease. Median follow\u2010up was 4.8\u00a0years. No patients were lost to follow\u2010up. Five\u2010year disease\u2010free and overall survival rates were 86% (no local or regional recurrences). Two patients developed vertebral metastases and died. Two required a temporary feeding tube for oral mucositis\/dysphagia. Late toxicities included symptomatic retinopathy, major reconstructive surgery, cataracts, chronic otitis media, chronic keratoconjunctivitis, hypothyroidism, and in\u2010field basal cell skin cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A multimodality approach for pediatric EN results in excellent local control. Despite the moderate\u2010dose PT, serious radiation toxicity was observed; further dose and target volume reductions may benefit select patients. Longer follow\u2010up and comparative data from modern photon series are necessary to fully characterize any relative PT advantage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30793","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T08:41:28Z","timestamp":1701247288000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes following proton therapy for pediatric esthesioneuroblastoma"],"prefix":"10.1002","volume":"71","author":[{"given":"Nicolette R.","family":"Drescher","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5765-1873","authenticated-orcid":false,"given":"Daniel J.","family":"Indelicato","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roi","family":"Dagan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam L.","family":"Holtzman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond B.","family":"Mailhot Vega","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp R.","family":"Aldana","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Florida College of Medicine Jacksonville  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Sandler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nemours Children's Specialty Clinic  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher G.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William M.","family":"Mendenhall","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida College of Medicine  Jacksonville Florida 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