Concurrent chemoradiotherapy for locally advanced unresectable adenoid cystic carcinoma of head and neck: experience from a single institute

Swain, Monali; Ghosh‐Laskar, Sarbani; Budrukkar, Ashwini; Patil, Roshan; Murthy, Vedang; Gupta, Tejpal; Mummudi, Naveen; Prabhash, Kumar; Joshi, Amit; Patil, Vijay Maruti; Naronha, Vanita; Agarwal, Jai Prakash

doi:10.1007/s00405-021-06654-3

Cited by 8 publications

(4 citation statements)

References 38 publications

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“…Upfront surgery is the mainstay of treatment for ACC, because, similar to other salivary gland tumors, ACC is minimally radio-and chemosensitive and does not show durable responses to these treatments. 3,17,18 Previous studies of sinonasal and major salivary gland ACC have demonstrated a survival benefit in patients treated with surgery, but these studies did not conduct separate analyses for very advanced-stage tumors. 19,20 In this study, we found that surgical treatments were associated with longer survival in T4b ACC of the head and neck.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment in Very Advanced (T4b) Adenoid Cystic Carcinoma of the Head and Neck

Papazian

Chow

Oliver

et al. 2023

Otolaryngol.--head neck surg.

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Objective To compare treatment outcomes for T4b head and neck adenoid cystic carcinoma (ACC). Study Design Historical cohort study. Setting National Cancer Database (NCDB). Methods Identified all T4b ACC of head and neck origin diagnosed 2004 to 2019 in the NCDB. Demographics, clinical characteristics, treatment details, and survival were analyzed. Treatment outcomes were analyzed using univariable and multivariable Cox regression. Results We identified 606 cases of T4b ACC. Less than half (284, 47.0%) underwent curative‐intent treatment. Among these, most were treated with primary surgery: surgery + radiotherapy (RT) (122, 43.0%) or surgery + chemoradiotherapy (CRT) (42, 14.8%). The positive margin rate was 78.7%, and 90‐day postoperative mortality was zero. Nonsurgical patients were treated with definitive RT (60, 21.1%) or definitive CRT (60, 21.1%). The median follow‐up was 51.5 months. Overall survival was 77.8% at 3 years. Three‐year survival was higher for patients treated with surgery compared to those treated nonsurgically (84% vs 70%; p = .005). Surgical treatment remained associated with higher survival on multivariable analysis (hazard ratio [HR]: 0.47, p = .005). This effect was most pronounced for oral cavity tumors (HR: 0.17, p = .01). Among matched cohorts of surgically treated patients, there was no difference in 3‐year survival between clinical T4a and T4b tumors (83.3% vs 83.0%, p = .99). Conclusion Long‐term survival for T4b ACC of the head and neck could be expected. Primary surgical treatments can be performed safely and are associated with longer survival. A carefully selected subset of patients with very advanced ACC might benefit from the consideration of surgical treatments.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment in Very Advanced (T4b) Adenoid Cystic Carcinoma of the Head and Neck

Papazian

Chow

Oliver

et al. 2023

Otolaryngol.--head neck surg.

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“…Grade 3 mucositis affected 5 patients (11.4%) as an acute adverse event. 38 Another study by Swain 39 retrospectively analyzed 23 patients with locally advanced HNACC who underwent definitive chemoradiotherapy from 2011 to 2018. 74% of these patients received IMRT.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Impact of Charged Particle Radiation Therapy for Head and Neck Adenoid Cystic Carcinoma: A Systematic Review and Meta-Analysis

Tan,

Chen,

et al. 2024

Technol Cancer Res Treat

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Purpose: Head and neck adenoid cystic carcinoma (HNACC) is a radioresistant tumor. Particle therapy, primarily proton beam therapy and carbon-ion radiation, is a potential radiotherapy treatment for radioresistant malignancies. This study aims to conduct a meta-analysis to evaluate the impact of charged particle radiation therapy on HNACC. Methods: A comprehensive search was conducted in Pubmed, Cochrane Library, Web of Science, Embase, and Medline until December 31, 2022. The primary endpoints were overall survival (OS), local control (LC), and progression-free survival (PFS), while secondary outcomes included treatment-related toxicity. Version 17.0 of STATA was used for all analyses. Results: A total of 14 studies, involving 1297 patients, were included in the analysis. The pooled 5-year OS and PFS rates for primary HNACC were 78% (95% confidence interval [CI] = 66-91%) and 62% (95% CI = 47-77%), respectively. For all patients included, the pooled 2-year and 5-year OS, LC, and PFS rates were as follows: 86.1% (95% CI = 95-100%) and 77% (95% CI = 73-82%), 92% (95% CI = 84-100%) and 73% (95% CI = 61-85%), and 76% (95% CI = 68-84%) and 55% (95% CI = 48-62%), respectively. The rates of grade 3 and above acute toxicity were 22% (95% CI = 13-32%), while late toxicity rates were 8% (95% CI = 3-13%). Conclusions: Particle therapy has the potential to improve treatment outcomes and raise the quality of life for HNACC patients. However, further research and optimization are needed due to the limited availability and cost considerations associated with this treatment modality.

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“…Therefore, the results regarding disease control, outcomes, toxicity may not be directly comparable to other historic photon-based series and contemporary series that primarily include photon-based IMRT for sinonasal ACC both few in number and small or combined with other histologies and/or primary sites. 3 , 14 , 15 , 16 , 17 , 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes Following Definitive or Adjuvant Proton Radiotherapy for Adenoid Cystic Carcinoma

Augustin,

Holtzman,

Dagan

et al. 2024

International Journal of Particle Therapy

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Concurrent chemoradiotherapy for locally advanced unresectable adenoid cystic carcinoma of head and neck: experience from a single institute

Cited by 8 publications

References 38 publications

Surgical Treatment in Very Advanced (T4b) Adenoid Cystic Carcinoma of the Head and Neck

Surgical Treatment in Very Advanced (T4b) Adenoid Cystic Carcinoma of the Head and Neck

Assessing the Impact of Charged Particle Radiation Therapy for Head and Neck Adenoid Cystic Carcinoma: A Systematic Review and Meta-Analysis

Long-Term Outcomes Following Definitive or Adjuvant Proton Radiotherapy for Adenoid Cystic Carcinoma

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