High-LET radiotherapy for adenoid cystic carcinoma of the head and neck: 15 years‿experience with raster-scanned carbon ion therapy

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• 作者：Alexandra D. Jensen^a ; ^{alexdjensen@gmx.de" class="auth_mail" title="E-mail the corresponding author} ; Melanie Poulakis^a ; ^{Melaniepoulakis@aol.com" class="auth_mail" title="E-mail the corresponding author} ; Anna V. Nikoghosyan^a ; ^{Anna.nikoghosyan@helios-kliniken.de" class="auth_mail" title="E-mail the corresponding author} ; Thomas Welzel^a ; ^{thomas.welzel@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Matthias Uhl^a ; ^{matthias.uhl@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Philippe A. Federspil^b ; ^{philippe.federspil@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Kolja Freier^c ; ^{kolja.freier@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Jü ; rgen Krauss^d ; ^{juergen.krauss@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Angelika Hö ; ss^e ; ^{angelika.hoess@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Thomas Haberer^f ; ^{Thomas.haberer@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Oliver Jä ; kel^f ; ^{Oliver.jaekel@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Marc W. Mü ; nter^a ; ^{m.muenter@klinikum-stuttgart.de" class="auth_mail" title="E-mail the corresponding author} ; Daniela Schulz-Ertner^a ; ^{daniela.ertner@fdk.info" class="auth_mail" title="E-mail the corresponding author} ; Peter E. Huber^g ; ^{p.huber@dkfz-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Jü ; rgen Debus^a ; ^{juergen.debus@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Adenoid cystic carcinoma ; ACC ; Malignant salivary gland tumors ; MSGTs ; Carbon ions ; Carbon ion therapy ; Raster-scanning ; IMRT
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：118
• 期：2
• 页码：272-280
• 全文大小：585 K

文摘

Locoregional control (LC) in malignant salivary gland tumors is dose-dependent, initial results with particle therapy were promising. We report our experience with raster-scanned, intensity-controlled carbon ion therapy (C12) and IMRT in 309 patients with pathologically confirmed adenoid cystic carcinoma (ACC) of the head and neck.

Patients and methods

Treatment records of patients treated with C12 between 08/1998 and 05/2013 were evaluated regarding tumor stage, treatment, toxicity (CTCAE v3), LC, progression-free survival (PFS) and overall survival (OS). Response assessment was carried out according to RECIST1.1.

Results

Tumor stages were mostly advanced (T4a/b: 60%, macroscopic disease: 71%), most common sites of origin were the paranasal sinus (37%). At a median follow-up at 33.9 months, LC, PFS, and OS at 3 and 5 year estimates are 83.7%/58.5%, 67.8%/56.1%, and 88.9%/74.6%. LC correlates with T-stage but neither nodal stage, age, relapse state, nor margin status. RECIST did not correlate with LC or survival rates.

Conclusion

IMRT plus C12 boost results in good control and survival rates at moderate toxicity. Margin status did not correlate with LC in T4 tumors, extensive and potentially mutilating surgical procedures may have to be re-evaluated.

RECIST assessment did not correlate with either LC or survival rates; potentially more meaningful radiological parameters need to be developed.