Clinical outcomes of head and neck adenoid cystic carcinoma patients treated with pencil beam-scanning proton therapy.

Pelak, Maciej J; Walser, Marc; Bachtiary, Barbara; Hrbacek, Jan; Lomax, Anthony J; Kliebsch, Ulrike L; Beer, Jürgen; Pica, Alessia; Malyapa, Robert; Weber, Damien C. (2020). Clinical outcomes of head and neck adenoid cystic carcinoma patients treated with pencil beam-scanning proton therapy. Oral oncology, 107, p. 104752. Elsevier 10.1016/j.oraloncology.2020.104752

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OBJECTIVE

The aim of this study was to evaluate the outcome of patients with head and neck adenoid cystic carcinoma (ACC) treated using pencil beam scanning proton therapy (PBS PT) at our institution.

MATERIALS AND METHODS

Thirty-five patients who underwent treatment with PBS PT for ACC between 2001 and 2017 were included. Local control (LC), distant control (DC), progression-free survival (PFS), overall survival (OS) and their prognostic factors were evaluated. Adverse effects were prospectively assessed.

RESULTS

The median patient follow-up was 30 months. Prior to PT, 26 patients (74.3%) underwent surgery with R0/R1/R2 outcome in 5, 13 and 8 cases, respectively. Nine patients (25.7%) presented with inoperable disease. The 2-year LC, DC, PFS and OS was 92.2%, 77.8%, 74.3% and 88.8%, respectively. LC was influenced by patient age (p = 0.002) with a significant difference between local and distant failure (median 61.3 vs. 42.3 years, p = 0.005). Tumor T stage was a significant risk factor for PFS (p = 0.045) and tumor prognostic group affected OS (p = 0.049). No significant survival advantage for operable vs. inoperable disease could be identified. The acute and late grade 3 toxicity rates were 14.3% and 6.1%, respectively. No acute or late grade 4/5 toxicities were observed.

CONCLUSIONS

PBS PT is an effective and safe treatment for patients with head & neck ACC in both definitive and adjuvant setting. Distant metastases are the main pattern of failure. Age, tumor stage and clinical stage had a significant negative impact on LC, OS and PFS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Pica, Alessia and Weber, Damien Charles

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1368-8375

Publisher:

Elsevier

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

08 Jun 2020 14:07

Last Modified:

02 Aug 2020 01:32

Publisher DOI:

10.1016/j.oraloncology.2020.104752

PubMed ID:

32413727

Uncontrolled Keywords:

Adenoid cystic carcinoma Adjuvant Definitive Distant metastasis Local tumor control Pencil beam scanning Prognostic factors Proton therapy

BORIS DOI:

10.7892/boris.144289

URI:

https://boris.unibe.ch/id/eprint/144289

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