【Objective】 To investigate the clinical features

prognosis

and appropriate treatment modalities for esthesioneuroblastoma (ENB). 【Methods】 44 patients with diagnoses of ENB were treated in our hospital through July 1986 to Febuary 2007. 19 patients were with Kadish stage A/B disease

and 25 with Stage C/D. In treatment

9 patients received surgery (SURG) alone and 6 received radiotherapy (RT) alone

3 received chemotherapy (CT) alone and 10 patients received surgery followed by radiotherapy (SURG + RT)

1 patients received chemotherapy followed by surgery (CT + SURG) and 15 received combined chemoradiotherapy (CRT). 【Results】 In early stage patients

the 5-year local control (LC) rate were 62.5% for patients received SURG (alone and with CT or RT) and 50.0% for those not received SURG (RT alone

CT alone

and CRT)(χ2 = 3.5

P = 0.06)

and 5-year rates of overall survival (OS) and progress-free survival (PFS) of them were 51.9% vs 16.7%(χ2 = 4.5

P = 0.03) and 38.5% vs 16.7%

respectively. Compared with SURG alone

the following adjuvant RT improved the 5-year LC rates (80% and 47.6%). RT and CT were the main treatment for advance stage patients. Comprehensive treatment was superior to single treatment. The total effective rate to initial chemotherapy was 100% (PR and SD). There was no in-field recurrence in the 7 patients of cervical lymph node metastasis treated with RT. By contrast

5 of 33 cervical lymph node-negative patients (15.2%) experienced neck node recurrence when elective neck fields were omitted. Four of five patients with neck recurrence had modified Kadish stage C at diagnosis. The frequent levels of regional recurrence were levels Ib

II

and III of neck (80%). 【Conclusions】 SURG plus Post-RT was the primary treatment for early stage ENB. Combined treatment is one of the most important treatment methods for advanced ENB. RT can effectively control the cervical lymph node metastasis

elective Upper neck RT should be considered in the treatment of modified Kadish stage C disease.