1
|
Phillips AL, Li C, Liang J, Sheyn A, Rastatter JC, Chelius DC, Orbach D, Richard C. Adenoid cystic carcinoma of the parotid and submandibular glands in children and young adults: A population-based study. Pediatr Blood Cancer 2024; 71:e30928. [PMID: 38418934 PMCID: PMC10959679 DOI: 10.1002/pbc.30928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES This study aims to analyze the behavior and treatment of adenoid cystic carcinoma (AdCC) in the pediatric and young adult population and to identify factors affecting overall survival (OS). MATERIALS AND METHODS The study analyzed salivary gland malignancies in patients aged 0-21 with AdCC histology using the National Cancer Database from 2004 to 2018. RESULTS A total of 72 patients (59.7% parotid, 36.1% submandibular, 1.4% sublingual, 2.8% unspecified) met criteria. Median age was 18 years [range: 0-21]. High-grade dysplasia was present in 67% of cases. Therapy consisted of primary surgery for all cases, regional lymph node dissection (LND) (74%), radiotherapy (71%), chemotherapy (8%), and chemoradiation (7%). The 5-year OS rate was 93.2% [95% confidence interval (CI): 86.9%-99.9%], respectively. Patients who underwent associated LND had improved OS (p = .0083, log-rank test) with a 5-year OS at 82.4% [95% CI: 66.1%-100%] versus 97.6% [95% CI: 93.0%-100%]. A significant difference in OS was found with unfavorable outcomes after positive marginal status: 5-year OS 84.1% [95% CI: 71.0%-99.7%] versus 100% [95% CI: 100%]; p < .001. Adjuvant therapy did not seem to impact the outcome. CONCLUSION This study confirms that AdCC in children and young adults has an overall good prognosis despite frequent high grade. It suggests that cervical LND may be of importance, but the value of systematic adjuvant therapy is not confirmed. These findings emphasize the importance and relevance of population-based studies in shaping clinical practice and informing the design of future prospective investigations.
Collapse
Affiliation(s)
- Alisa L Phillips
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
| | - Cai Li
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jia Liang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Anthony Sheyn
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jeffrey C Rastatter
- Division of Pediatric Otolaryngology - Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniel C Chelius
- Department of Otolaryngology - Head and Neck Surgery, Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Celine Richard
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
2
|
Scarpa A, Viola P, Ralli M, Gioacchini FM, Salzano G, Di Stadio A, Cassandro C, Chiarella G, Ricciardiello F, De Luca P, Salzano FA, Avallone E. Post-operative radiotherapy in adenoid cystic carcinoma of salivary glands versus surgery alone: what is the evidence about survival and local control? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:563-571. [PMID: 37796320 DOI: 10.1007/s00405-023-08252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Adenoid cystic carcinoma of the salivary glands is a relatively rare malignancy characterized by slow growth and a poor prognosis, and effective treatments remain challenging to identify. This systematic review, following the PRISMA guidelines, aimed to analyze the potential benefits of post-operative radiotherapy in terms of local control of recurrences and survival advantages when compared with surgery alone in patients with adenoid cystic carcinoma. METHODS A comprehensive systematic review was conducted by searching the MEDLINE, Cochrane, EMBASE, and OVID databases from January 1999 to July 2022. The goal was to identify articles comparing surgery alone with surgery plus postoperative radiotherapy for adenoid cystic carcinoma of the salivary glands. Downs and Black Checklist was used to assess the methodological quality and risk of bias of each included study. The data analysis was performed using Review Manager version 5.4.1. RESULTS This review included 8 studies comprising a total of 3103 patients, divided based on the analyzed outcomes. The pooled odds ratio for overall survival at 5 years was 0.87 (95% confidence interval 0.43-1.76, p = 0.70), and at 10 years was 1.23 (95% confidence interval 0.69-2.16, p = 0.48). In both cases, no statistically significant differences were observed. However, the pooled odds ratio for local control at 5 years was 3.37 (95% confidence interval 1.35-8.42, p = 0.009), providing strong support for the use of post-operative radiation. CONCLUSIONS The findings from the meta-analysis suggest that post-operative radiotherapy significantly improves local control in patients with adenoid cystic carcinoma. However, there was no statistically significant increase in survival at 5 and 10 years. It is essential to note that the quality of the studies included in this meta-analysis ranged from fair to poor. To better clarify the indications for post-operative radiotherapy, future high-quality research is needed, particularly with improved stratification of patient groups. Additionally, it is important to recognize that achieving local control in adenoid cystic carcinoma is crucial for enhancing the overall quality of life for patients. We acknowledge that this review was not registered in the PROSPERO database, and the data pooling was conducted using a random effects model.
Collapse
Affiliation(s)
- Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, Salerno, SA, Italy.
| | - Pasquale Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Federico Maria Gioacchini
- ENT Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - Arianna Di Stadio
- Department GF Ingrassia, University of Catania, 95123, Catania, Italy
| | | | - Giuseppe Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | | | - Pietro De Luca
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Via Dell'Amba Aradam, 8, 00184, Rome, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry, University of Salerno, Largo Città di Ippocrate, Salerno, SA, Italy
| | - Emilio Avallone
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover, Germany
| |
Collapse
|
3
|
Qiu Z, Wu Z, Zhou X, Tao Y, Su Y. Omission of radiotherapy to lymph node level III in patients with cN0 adenoid cystic carcinoma of the major salivary gland: a single center experience. Radiol Med 2024; 129:335-345. [PMID: 38308063 DOI: 10.1007/s11547-024-01763-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/03/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE Due to the rarity of adenoid cystic carcinoma (ACC) of the major salivary gland, there is no consensus on the extent of prophylactic neck irradiation (PNI) for patients with clinically negative lymph nodes (cN0) disease. MATERIALS AND METHODS We conducted a retrospective analysis of all patients with ACC of the major salivary gland who received treatment at our center between January 2010 and April 2020. The primary endpoint was regional failure-free survival (RRFS). Secondary endpoints included overall survival (OS), distant metastasis-free survival (DMFS), local recurrence-free survival (LRFS), and acute toxicity. RESULTS A total of 139 patients were included in the analysis. For cN0 patients, the 5-year RRFS, OS, DMFS, and LRFS were 93.2%, 90.2%, 75.7%, and 91.4%, respectively. Multivariate analysis revealed that PORT was an independent prognostic factor for RRFS and LRFS. No statistically significant differences were observed between the Level III sparing PNI group and the Standard PNI group in terms of RRFS, OS, DMFS, and LRFS. The doses delivered to the larynx and thyroid in the Level III sparing PNI group were significantly lower than those in the Standard PNI group. CONCLUSION In patients with cN0 ACC of the major salivary gland, PNI improves regional control, and the level III nodal region sparing radiotherapy does not increase the risk of level III recurrence, while potentially reducing toxicity.
Collapse
Affiliation(s)
- Zichen Qiu
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Zheng Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 283 Tong Zi Po Road, Changsha, 410013, People's Republic of China
| | - Xiong Zhou
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China
| | - Yalan Tao
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China.
| | - Yong Su
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China.
| |
Collapse
|
4
|
Hong S, Garces YI, Price KA, Shinya Y, Parney IF, Link MJ, Pollock BE. Treatment outcomes of single-fraction stereotactic radiosurgery for adenoid cystic carcinoma: a case series of 55 patients. J Neurooncol 2024; 166:369-376. [PMID: 38180687 DOI: 10.1007/s11060-024-04561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/02/2024] [Indexed: 01/06/2024]
Abstract
PURPOSE This study aimed to analyze the treatment outcomes of single-fraction stereotactic radiosurgery (SRS) for adenoid cystic carcinoma patients. METHODS Retrospective analysis was conducted for 55 patients with 66 lesions. SRS intentions were categorized as definitive, adjuvant, salvage, and palliative. Tumor control was defined as local (within 50% isodose line), marginal (outside 50% isodose line), and distant (metastasis outside head/neck). RESULTS The median age was 60 years (range 21-85), with 53% males. Tumor origin was head/neck for 88% and trachea/lung for 12%. 61% were recurrent lesions. Median interval from diagnosis to SRS was 14 months. Preceding surgery was performed in 30%. SRS was administered as definitive (30 lesions), adjuvant (13), salvage (19), and palliative (4). SRS was used as a boost to external beam radiation therapy (EBRT) in 39%. Concurrent chemotherapy was administered in 26%. 5-, 10-, and 15-year local control rates were 60%, 33%, and 27%, respectively; local/marginal control rates were 29%, 13%, and 10%. For recurrent lesions treated with SRS without EBRT, 5-year local control rate was 14%, and local/marginal control rate was 5%. For recurrent lesions treated with SRS and EBRT, 5-year local control rate was 100%, and local/marginal control rate was 40%. The rate of distant failure after SRS was 40%. Older age and distant metastasis before SRS were negative factors for overall survival. CONCLUSION SRS provided a high rate of local tumor control, but marginal failure was frequent. Integrating SRS with added EBRT exhibits potential for enhancing local and local/marginal tumor control, particularly in recurrent cases.
Collapse
Affiliation(s)
- Sukwoo Hong
- Department of Neurological Surgery, Mayo Clinic, 200 First Street Southwest, 55905, Rochester, Minnesota, USA
| | - Yolanda I Garces
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Katharine A Price
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Yuki Shinya
- Department of Neurological Surgery, Mayo Clinic, 200 First Street Southwest, 55905, Rochester, Minnesota, USA
| | - Ian F Parney
- Department of Neurological Surgery, Mayo Clinic, 200 First Street Southwest, 55905, Rochester, Minnesota, USA
| | - Michael J Link
- Department of Neurological Surgery, Mayo Clinic, 200 First Street Southwest, 55905, Rochester, Minnesota, USA
| | - Bruce E Pollock
- Department of Neurological Surgery, Mayo Clinic, 200 First Street Southwest, 55905, Rochester, Minnesota, USA.
| |
Collapse
|
5
|
Nakamura M, Ohnishi K, Nakazawa K, Shimizu K, Miyauchi D, Mizumoto M, Nakai K, Okumura T, Sakurai H. Long-term follow-up of unresectable adenoid cystic carcinoma of the trachea and bronchus treated with high-dose proton beam therapy: A report of two cases. Thorac Cancer 2024; 15:201-205. [PMID: 37984929 PMCID: PMC10788470 DOI: 10.1111/1759-7714.15158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) of the trachea is a rare disease that is slow growing and has a risk of distant metastasis. The standard treatment for ACC of the trachea is surgery, but this tumor is often unresectable. In definitive radiotherapy using photons for unresectable ACC of the trachea, it is sometimes difficult to deliver a sufficient dose to the target without exceeding the tolerable dose to the surrounding normal tissues. Here, we report two cases of ACC of the trachea that received a high dose (74 Gy [relative biological effectiveness]) of proton beam therapy and achieved long-term survival.
Collapse
Affiliation(s)
- Masatoshi Nakamura
- Department of Radiation Oncology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
| | - Kayoko Ohnishi
- Department of Radiation Oncology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
- Department of Radiology, School of MedicineInternational University of Health and WelfareChibaJapan
| | - Kensuke Nakazawa
- Department of Respiratory Medicine, Faculty of MedicineUniversity of TsukubaIbarakiJapan
| | - Kei Shimizu
- Department of Respiratory MedicineHitachi General HospitalIbarakiJapan
| | - Daigo Miyauchi
- Department of Health ScreeningSakuragawa Regional Medical CenterIbarakiJapan
| | - Masashi Mizumoto
- Department of Radiation Oncology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
| | - Kei Nakai
- Department of Radiation Oncology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
| | - Toshiyuki Okumura
- Department of Radiation Oncology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
- Department of Radiation OncologyIbaraki Prefectural Central HospitalIbarakiJapan
| | - Hideyuki Sakurai
- Department of Radiation Oncology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
| |
Collapse
|
6
|
Mauthe T, Holzmann D, Soyka MB, Mueller SA, Balermpas P, Held U, Freiberger SN, Rupp NJ, Meerwein CM. Overall and disease-specific survival of sinonasal adenoid cystic carcinoma: a systematic review and meta-analysis. Rhinology 2023; 61:508-518. [PMID: 37703531 DOI: 10.4193/rhin23.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
This meta-analysis aims to investigate the outcome of sinonasal adenoid cystic carcinoma (snAdCC). We followed PRISMA guidelines and included studies reporting 5-year overall survival (OS) rates for snAdCC. Eligible studies were identified through a literature search and assessed using JBI critical appraisal checklist. A total of 17 studies were included comprising 2259 patients (mean age: 58.1 years, 52.7% female, 47.3% male). The meta-analysis demonstrated that the 5-year OS, 10-year OS, and 5-year disease-free survival (DFS) were 68%, 40%, and 47.2%, respectively. Descriptive statistics on study level showed high rates of locally advanced tumor stages at diagnosis: 23% cT3, 53% cT4, 3.4% N+, and 4.2% M+. 29.7% of the tumors were in the nasal cavity, 67.6% in the paranasal sinuses. The maxillary, ethmoid, sphenoid, and frontal sinus were affected in 50.9%, 7.2%, 4%, and 0.5%, of cases. A combination of surgery and radiotherapy was used in 45.4% of the patients and 19.3% of patients received surgery only. In conclusion, these findings emphasize the significance of thorough surveillance for individuals with snAdCC to identify any potential recurrence or progression of the disease.
Collapse
Affiliation(s)
- T Mauthe
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - S A Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - P Balermpas
- Department of Radiation Oncology, University Hospital of Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - U Held
- Department of Biostatistics at Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - S N Freiberger
- Department of Biostatistics at Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - N J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - C M Meerwein
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
7
|
Fu Z, Xu X, Bao Y, Chen Z, Zhong J, Zhou S. Successful surgery with preservation of laryngeal function in a patient with collision primary squamous cell carcinoma and adenoid cystic carcinoma in the hypopharynx and synchronous esophageal carcinoma: A case report. Head Neck 2023; 45:E53-E60. [PMID: 37671671 DOI: 10.1002/hed.27507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/28/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The definition of "collision tumor" is the coexistence of two histologically and morphologically distinct tumors within the same anatomical area without histological admixture. Collision tumors featuring primary squamous cell and adenoid cystic carcinomas of the hypopharynx, combined with synchronous esophageal carcinoma, are very rare. METHODS We describe a patient with a collision tumor of the hypopharynx and synchronous esophageal carcinoma who underwent partial laryngectomy, with preservation of laryngeal function, and radical esophageal resection featuring esophageal reconstruction using a gastric tube. Surgery was successful. RESULTS Postoperative radiotherapy was recommended after surgery; the patient exhibited no recurrence or distant metastasis to the 17-month follow-up. CONCLUSION To the best of our knowledge, this is the first report of collision of primary squamous cell carcinoma and adenoid cystic carcinoma in the hypopharynx and synchronous esophageal carcinoma. We performed appropriate surgery and prescribed postoperative radiotherapy. This preserved laryngeal function.
Collapse
Affiliation(s)
- Ziming Fu
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaolong Xu
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yangyang Bao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Chen
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jiangtao Zhong
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shuihong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
8
|
Kinoshita T, Ishii H, Sakazaki Y, Azuma K, Sasaki J, Tokito T, Tominaga M, Ogou E, Kawayama T, Hoshino T. Proton Beam Therapy as a Curative Treatment for a Young Case of Unresectable Tracheal Adenoid Cystic Carcinoma. Intern Med 2023; 62:2877-2881. [PMID: 36792199 PMCID: PMC10602834 DOI: 10.2169/internalmedicine.0574-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/28/2022] [Indexed: 02/16/2023] Open
Abstract
Primary tracheal adenoid cystic carcinoma (TACC) is a rare malignancy without an established treatment. Central airway obstruction due to TACC often decreases the quality of life and has life-threatening consequences. A 19-year-old man with unresectable TACC and central airway obstruction suffered from progressive cough and dyspnea after exercise. Proton beam therapy (PBT) was selected as the preferred treatment over systemic anti-cancer chemotherapy for TACC. PBT led to complete remission of TACC and the almost complete disappearance of the respiratory symptoms without adverse events. PBT is a useful and safe treatment for unresectable primary TACC.
Collapse
Affiliation(s)
- Takashi Kinoshita
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Yuki Sakazaki
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Jun Sasaki
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Masaki Tominaga
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Etsuyo Ogou
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Japan
| |
Collapse
|
9
|
Mahé M, Beddok A, Goudjil F, Ala Eddine C, Bolle S, Champion L, Feuvret L, Herman P, Zefkili S, Choussy O, Le Tourneau C, Dendale R, Buvat I, Sauvaget E, Créhange G, Calugaru V. Curative high-dose reirradiation for patients with recurrent head and neck adenoid cystic carcinomas: outcomes and analysis of patterns of failure. Int J Radiat Biol 2023; 100:79-86. [PMID: 37526368 DOI: 10.1080/09553002.2023.2242934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND To investigate the outcomes of patients who underwent curative reirradiation (reRT), with intensity-modulated radiation therapy (IMRT) or proton therapy (PT) for unresectable recurrent or second primary head and neck adenoid cystic carcinoma (HNACC). METHODS Ten patients, mostly KPS 90%, were reirradiated (3/10 with IMRT and 7/10 with PT) at a median maximum dose to the CTV of 64.2 Gy from July 2011 to November 2021. Locations at the time of reRT were mainly the sinus (4/10) and the salivary glands (including the parotid and submandibular gland, 3/10). CTCAEv5 was used to assess acute and late toxicities. Follow-up was the time between the end of reRT and the date of last news. RESULTS The median time between the two irradiations was 53.5 months (IQR: 18-84). After a median follow-up of 26 months (range, 12.5-51.8 months), six patients had developed a locoregional recurrence (LR), of which four occurred within the previously irradiated volume. Two and three-year locoregional failure-free survival (LFFS) and overall survival (OS) were 55.6% [95%CI: 31-99.7%], and 41% [18.5-94%] and 66.7% [42-100%] and 44.4% [21.4-92.3%], respectively. LFFS and OS were significantly better in the subgroup of sinus tumors (p = .013) and the subgroup of patients re-irradiated more than two years after the first course of irradiation (p = .01). Seven patients had impairments before the start of reRT, including hearing impairment (3/10) and facial nerve impairment (3/10). The most severe late toxicities were brain necrosis (2/10), osteoradionecrosis (1/10) and vision decreased (1/10). CONCLUSION Curative reRT for HNACC is possible for selected cases, but the LR rate in the irradiated field and the risk of severe toxicity remain high. Improved selection criteria and more carefully defined target volumes may improve outcome in these patients. A further study including larger cohort of patients would be useful to confirm these results.
Collapse
Affiliation(s)
- Mathilde Mahé
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Arnaud Beddok
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
- Institut Curie. PSL Research University. University Paris Saclay. Inserm LITO U1288 Orsay, Paris, France
| | - Farid Goudjil
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | | | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy Campus, Villejuif, France
| | | | - Loïc Feuvret
- Department of Radiation Therapy, East Group Hospital. Hospices Civils de Lyon, Lyon, France
| | - Philippe Herman
- Department of Head and Neck Surgery, Lariboisière Hospital. APHP. Nord. Université Paris Cité, Paris, France
| | - Sofia Zefkili
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Olivier Choussy
- Department of Head and Neck Surgery. Institut Curie, Paris/Saint-Cloud, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), INSERM U900 Research unit. Paris-Saclay University. Institut Curie, Paris, France
| | - Remi Dendale
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Irene Buvat
- Institut Curie. PSL Research University. University Paris Saclay. Inserm LITO U1288 Orsay, Paris, France
| | - Elisabeth Sauvaget
- Department of Head and Neck Surgery, Saint-Joseph Hospital, Paris, France
| | - Gilles Créhange
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Valentin Calugaru
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| |
Collapse
|
10
|
Barcellini A, Fontana G, Filippini DM, Ronchi S, Bonora M, Vischioni B, Ingargiola R, Camarda AM, Loap P, Facchinetti N, Licitra L, Baroni G, Orlandi E. Exploring the role of neutrophil-to-lymphocyte ratio and blood chemistry in head and neck adenoid cystic carcinomas treated with carbon ion radiotherapy. Radiother Oncol 2022; 177:143-151. [PMID: 36328091 DOI: 10.1016/j.radonc.2022.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/26/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE In recent years, there is an emerging interest in the prognostic role of chemistry blood biomarkers in oncological patients but their role in adenoid cystic carcinomas (ACCs) is still unknown. This study aims to assess the prognostic significance of baseline neutrophil-to-lymphocyte ratio (NLR) and blood chemistry in a series of head and neck ACC patients treated with carbon ion radiotherapy (CIRT). MATERIAL AND METHODS We retrospectively retrieved the data of 49 consecutive head and neck ACC patients treated with CIRT. Univariable and multivariable Cox proportional hazard regression (Cox-ph) analyses were performed to look for a potential association of NLR, and other blood biomarker values, with disease-free survival (DFS), Local Control (LC), Metastasis Free Survival (MFS) and overall survival (OS). RESULTS No significant association between NLR > 2,5 and DFS, LC, MFS and OS was found with univariable analysis although a trend was reported for DFS (Hazard ratio [HR]: 2,10, 95 % CI: 0,85 - 5,08, p-value = 0,11). Patients with hemoglobin (hb) ≤ 14 g/dL showed significantly better DFS, MFS and OS. Multivariable regression Cox-ph analysis for DFS, adjusted for margin status, clinical target volume and Absolute Number of Monocytes, reported the following statistically significant HRs, for both NLR > 2,5 and hb > 14 g/dL respectively: 4,850 (95 % CI = 1,408 - 16,701, p = 0,012) and 3,032 (95 % CI = 1,095 - 8,393, p = 0,033). Moreover, hb > 14 with HR = 3,69 (95 % CI: 1,23 - 11,07, p-value = 0,02), was a negative independent prognostic predictor for MFS. CONCLUSIONS Pre-treatment NLR and hb values seem to be independent prognostic predictor for clinical outcomes in head and neck ACC patients. If their role will be validated in a larger prospective cohort, they might be worthwhile for a pre-treatment risk stratification in patients treated with CIRT.
Collapse
Affiliation(s)
- Amelia Barcellini
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Giulia Fontana
- Clinical Bioengineering Unit, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Daria Maria Filippini
- Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola Malpighi, Bologna, Italy
| | - Sara Ronchi
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.
| | - Maria Bonora
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Barbara Vischioni
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Rossana Ingargiola
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Anna Maria Camarda
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Pierre Loap
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Nadia Facchinetti
- Scientific Direction, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Lisa Licitra
- Scientific Direction, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy; Head and Neck Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Guido Baroni
- Clinical Bioengineering Unit, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy; Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | - Ester Orlandi
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| |
Collapse
|
11
|
Weusthof K, Debus J, Adeberg S. [Radiation therapy of malignant salivary gland tumors]. HNO 2022; 71:243-249. [PMID: 35689095 DOI: 10.1007/s00106-022-01188-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/26/2022]
Abstract
Due to their rarity, histologic heterogeneity, and localization, treatment of malignant salivary gland tumors requires an interdisciplinary approach. First-line treatment includes complete tumor resection. Postoperative radiation therapy is advised in patients with risk factors, i.e., incomplete tumor resection, high-grade tumors, or perineural invasion. Definitive radiation therapy is only advised for inoperable tumors because of significantly lower local control and survival rates when compared to combined surgery and radiation therapy. In radiation oncology, modern techniques such as intensity-modulated radiation therapy (IMRT) or particle therapy with heavy ions (i.e., C12) have led to improved outcomes in the treatment of head and neck tumors, especially of adenoid cystic carcinomas. Given the biological and physical benefits of particles, particle therapy, particularly carbon ion radiation, is a promising therapeutic approach for salivary gland tumors that will be further investigated in prospective clinical studies.
Collapse
Affiliation(s)
- Katharina Weusthof
- Universitätsklinikum Heidelberg (UKHD) und Deutsches Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Deutschland.
- Abteilung für Radioonkologie, Universitätsklinikum Heidelberg (UKHD), Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD und DKFZ, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Jürgen Debus
- Universitätsklinikum Heidelberg (UKHD) und Deutsches Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Deutschland
- Abteilung für Radioonkologie, Universitätsklinikum Heidelberg (UKHD), Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD und DKFZ, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
- Heidelberger Ionenstrahl-Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Deutschland
| | - Sebastian Adeberg
- Universitätsklinikum Heidelberg (UKHD) und Deutsches Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Deutschland
- Abteilung für Radioonkologie, Universitätsklinikum Heidelberg (UKHD), Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD und DKFZ, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| |
Collapse
|
12
|
Wang Z, Wu R, Zhang J, Chen X, Wang J, Wang K, Qu Y, Huang X, Luo J, Xiao J, Xu G, Gao L, Yi J, Zhang Y. Omitting elective neck irradiation in clinically N0 sinonasal adenoid cystic carcinoma: A propensity score-matched analysis. Oral Oncol 2021; 124:105653. [PMID: 34871873 DOI: 10.1016/j.oraloncology.2021.105653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To explore the effects of elective neck irradiation (ENI) in clinically node-negative (cN0) sinonasal adenoid cystic carcinoma (SNACC). MATERIALS AND METHODS Between January 2000 and December 2016, 60 patients with cN0 sinonasal adenoid cystic carcinoma receiving surgery combined with radiotherapy were analyzed retrospectively, there were 39 received ENI (ENI group) and 21 with no ENI (non-ENI group). Propensity score matching (PSM) was performed to balance clinical factors and match patients. Kaplan-Meier method and Cox proportional hazard model were used to evaluate the impact of ENI on regional relapse risk and survival outcomes. RESULTS The median follow-up time for our cohort was 82.0 months (12.4-190.7 months). Four patients (6.7%) developed neck nodal relapses, with a median time to progression of 38.8 months. Among them, two patients in ENI group but failed out-field. After PSM, 21 patients were matched in each group. The 7-year regional relapse-free survival (RRFS), distant metastasis free survival (DMFS), progression-free survival (PFS), and overall survival (OS) between ENI group and non-ENI group were 85.4% vs 73.3% (p = 0.845), 65.2% vs 65.6% (p = 0.548), 68.3% vs 66.2% (p = 0.425), and 87.3% vs 84.0% (p = 0.953). Multivariate Cox analysis showed ENI was not an independent prognostic factor associated with RRFS, DMFS, PFS and OS. CONCLUSION Our findings firstly demonstrated the omission of elective neck irradiation in the management of cN0 sinonasal adenoid cystic carcinoma might be safe without compromising disease control and should be further investigated.
Collapse
Affiliation(s)
- Zekun Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianghu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesong Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingbo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
13
|
Zhao L, Zhao Y, Guo JD, Zeng Y, Yao F, Liu MN, Wang JM, Lv CX, Liu J, Fu XL, Zhao H, Cai XW. Effective Radiotherapy in Tracheobronchial Adenoid Cystic Carcinoma With Positive Surgical Margin. Ann Thorac Surg 2020; 112:1585-1592. [PMID: 33347849 DOI: 10.1016/j.athoracsur.2020.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/02/2020] [Accepted: 11/30/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The study aimed to evaluate the role of postoperative radiotherapy (PORT) in the treatment of trachea and main bronchus adenoid cystic carcinoma (ACC) with a positive surgical margin. METHODS Patients with pathologically confirmed trachea or main bronchus ACC operated on at Shanghai Chest Hospital were enrolled. Survival, univariate, and multivariate analyses were performed. The χ2 test was applied to analyze the failure patterns among different groups (R0/0: negative margin resection without PORT; R1/0: positive margin resection without PORT; R1/1: positive margin resection with PORT). RESULTS From January 2001 to December 2014, 77 patients were deemed eligible for the study. Pairwise comparisons showed that the overall survival rate of group R1/1 was comparable to that of group R0/0 (P = .438), and significantly longer than the rate of group R1/0 (P = .032). Additionally, the local disease-free survival rate of group R1/1 was much higher than that of group R0/0 (P = .023) and R1/0 (P = .001). Cox multivariate analysis identified the radiologic feature (P = .012) and PORT (P = .006) as significantly favorable prognostic factors for locoregional disease-free survival. By contrast, for overall survival, PORT (P = .032) was the only corresponding variable identified by univariate analysis. Furthermore, PORT significantly decreased the locoregional recurrence rate (P = .002) but not distant metastases (P > .999). CONCLUSIONS PORT helped patients with tracheobronchial ACC and microscopic positive surgical margins to achieve a similar outcome as patients with complete resection. R0 resection may not be necessary for tracheobronchial ACC if it is difficult to be completely resected.
Collapse
Affiliation(s)
- Lei Zhao
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Dong Guo
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ya Zeng
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Yao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mi-Na Liu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jia-Ming Wang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chang-Xing Lv
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Liu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Long Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Heng Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xu-Wei Cai
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
14
|
Chia N, Petersson F. Adenoid cystic carcinoma with dedifferentiation/expansion of the luminal cell component and preserved biphasic morphology - Early high-grade transformation. Ann Diagn Pathol 2020; 50:151650. [PMID: 33254086 DOI: 10.1016/j.anndiagpath.2020.151650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022]
Abstract
We present two patients (29 and 67 years) with histomorphologic and immunohistochemical evidence of early high-grade transformation of adenoid cystic carcinoma in the nasal cavity and floor of mouth, respectively. The component of early high-grade transformation was characterized by 1) selective expansion of the luminal (CK7+, c-kit+, p63-) cell component with severe cytologic atypia and significantly increased Ki-67 proliferation index, and 2) retained albeit attenuated abluminal (CK7-, c-kit-, p63+) cells, surrounding nests of high-grade luminal cells.
Collapse
Affiliation(s)
- Noel Chia
- Department of Pathology, National University Hospital, Singapore, 5 Lower Kent Ridge Road, Main Building Level 3, S(119074)
| | - Fredrik Petersson
- Department of Pathology, National University Hospital, Singapore, 5 Lower Kent Ridge Road, Main Building Level 3, S(119074).
| |
Collapse
|
15
|
Abstract
Sinonasal adenoid cystic carcinoma is a rare malignancy characterized by an insidious growth pattern and a tendency for perineural spread along major and minor nerves, resulting in invasion of the skull base and intracranial extension. Therefore, many patients present with advanced disease and involvement of critical structures, making treatment difficult and potentially associated with high morbidity. Surgery represents the mainstay of treatment of the primary tumor. Complete resection of the tumor with negative margins, whenever feasible, is associated with better survival outcomes. However, in the case of extensive involvement of vital structures (e.g., carotid artery, cavernous sinus, optic nerve, Meckel's cave) or when radical surgery could seriously affect the patient's quality of life, a function-preserving subtotal removal of the tumor followed by irradiation can be proposed. The role of surgery is limited to a biopsy in unresectable lesions that are more suitable for non-surgical treatments (e.g., exclusive chemoradiation). Given the difficulty in obtaining negative margins and the propensity for submucosal and perineural spread, adjuvant radiotherapy is strongly recommended. Recently, heavy-particle radiotherapy using protons or carbon ions has emerged as a promising treatment with improved local control. Local failures (60%) and distant metastases (40%) are common and can occur even decades after definitive treatment. The 5-year overall survival ranges from 55 to 70% and it exceeds that of other sinonasal malignancies, but dramatically drops down at 10 years (40%) and further decreases at 20 years (15%). Therefore, a prolonged follow-up of at least 15 years, and possibly lifelong, is mandatory.
Collapse
Affiliation(s)
- Paolo Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Mario Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy,
| |
Collapse
|
16
|
Kawakita D, Murase T, Ueda K, Kano S, Tada Y, Tsukahara K, Okami K, Onitsuka T, Fujimoto Y, Matoba T, Sakurai K, Nagao T, Hanai N, Kawata R, Hato N, Nibu KI, Urano M, Taguchi KI, Nakaguro M, Kusafuka K, Yamamoto H, Nagao T, Inagaki H. The impact of clinicopathological factors on clinical outcomes in patients with salivary gland adenoid cystic carcinoma: a multi-institutional analysis in Japan. Int J Clin Oncol 2020; 25:1774-1785. [PMID: 32613404 DOI: 10.1007/s10147-020-01731-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Owing to the low incidence of adenoid cystic carcinoma (AdCC), reliable survival estimates and prognostic factors remained unclarified. METHODS In this multi-institutional retrospective analysis, we collected 192 AdCC cases, and investigated the impact of clinicopathological factors on clinical outcomes of the patients. All AdCC cases were of salivary gland origin and were surgically treated with curative intent. Diagnoses of AdCC were validated by a central pathology review by expert pathologists. RESULTS The 5-year overall survival (OS) and disease-free survival (DFS) rates were 92.5 and 50.0%, respectively. Treatment failure occurred in 89 patients (46%) with the distant failures in 65 (34%). Multivariate analysis indicated that pN2 and a pathologically positive surgical margin were independent prognostic factors for both OS and DFS. Histological grade III was an independent prognostic factor for OS. A primary site in the submandibular gland, pT3/4, pN1, and histological grade II were independent prognostic factors for DFS. Postoperative radiation therapy (PORT) improved the locoregional control (LRC) rate. Prophylactic neck dissection was not associated with a better OS or better LRC among patients with cN0. Facial nerve dissection did not improve clinical outcomes in parotid AdCC cases without facial nerve palsy. CONCLUSIONS A higher TN classification, a pathologically positive surgical margin, and a higher histological grade were associated with a lower OS. PORT improved LRC rates but neck dissection failed to improve clinical outcomes in patients with cN0. As the distant metastasis was frequent, effective systemic therapy is imperative to improve the survival of AdCC patients.
Collapse
Affiliation(s)
- Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Kaori Ueda
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-ku, Nagoya, 467-8601, Japan
- Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, Mita Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuro Onitsuka
- Division of Head and Neck Surgery, Shizuoka Cancer Center, Mishima, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuma Matoba
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazuo Sakurai
- Department of Otorhinolaryngology, Fujita Health University, Toyoake, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ryo Kawata
- Department of and Otorhinolaryngology-Head and Neck Surgery, Osaka Medical College, Takatsuki, Japan
| | - Naohito Hato
- Department of Otolaryngology, Ehime University School of Medicine, Matsuyama, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Ken-Ichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | | | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate of School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-ku, Nagoya, 467-8601, Japan.
| |
Collapse
|
17
|
Hagiwara Y, Koto M, Bhattacharyya T, Hayashi K, Ikawa H, Nemoto K, Tsuji H. Long-term outcomes and toxicities of carbon-ion radiotherapy in malignant tumors of the sphenoid sinus. Head Neck 2020; 42:50-58. [PMID: 31584731 PMCID: PMC6973156 DOI: 10.1002/hed.25965] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/31/2019] [Accepted: 09/06/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Most of the primary sphenoid sinus tumors present with locally advanced stages with involvement of adjacent critical structures and are not amenable to radical resection. We sought to evaluate the safety and efficacy of carbon-ion radiotherapy (C-ion RT) for sphenoid sinus malignancies. METHODS This is a retrospective analysis of 22 patients of primary sphenoid carcinomas treated with definitive C-ion RT. RESULTS Adenoid cystic carcinoma was the most common histology (15 patients, 68.2%). The median follow-up of this cohort was 48.5 months. The actuarial local control and overall survival at 5 years were 51.0% and 62.7%, respectively. Grade 4 visual impairment and grade 4 brain necrosis were seen in six and one patient, respectively. CONCLUSION C-ion RT can provide a reasonably good clinical outcome in locally advanced sphenoid sinus malignancies with a marginally higher late toxicity profile because of extremely close proximity of the target volume to critical structures.
Collapse
Affiliation(s)
- Yasuhito Hagiwara
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tapesh Bhattacharyya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| |
Collapse
|
18
|
Xu N, Zheng L, Wu WJ, Huang MW, Zhang J, Zhang JG. Definitive 125I Brachytherapy of Locally Advanced Adenoid Cystic Carcinoma Involving the Skull Base With Satisfying Efficacy and Safety. J Oral Maxillofac Surg 2019; 77:2143-2153. [PMID: 31028735 DOI: 10.1016/j.joms.2019.03.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/24/2019] [Accepted: 03/24/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE Adenoid cystic carcinoma (ACC) involving the skull base is difficult to treat and sometimes unresectable. The purpose of this study was to evaluate the efficacy and safety of 125I radioactive seed interstitial brachytherapy for treatment of these patients. MATERIALS AND METHODS Patients with ACC involving the skull base treated by definitive 125I brachytherapy from March 2008 through December 2018 at the Peking University Hospital of Stomatology (Beijing, China) were retrospectively identified. Overall survival (OS), as the primary efficacy indicator, and progression-free survival (PFS) and distant metastasis-free survival (DFS), as the secondary efficacy indicators, were analyzed by Kaplan-Meier survival analysis and Cox regression analysis. Adverse radiotherapy (RT) reactions, as safety indicators, were recorded. RESULTS Thirty-two patients with (r)T4b locally advanced disease were enrolled. The prescription dose (PD) was 60 to 120 Gy. The dose delivered to 90% of the target volume was 99.1 to 145.2 Gy, the percentage of the target volume receiving at least 100% of the PD was at least 88.2%, and the percentage of the target volume receiving at least 150% of the PD was smaller than 74.0%. Mean follow-up was 32 months (median, 21 months; range, 3 to 95 months). The 1- and 3-year OS rates were 93.3 and 62.6%, the 1- and 3-year PFS rates were 90.0 and 46.4%, and the 1- and 3-year DFS rates were 91.7 and 61.1%, respectively. Survival was significantly associated with local recurrence (P = .04) and distant metastasis except in the lung (P = .05). The rate of severe chronic adverse RT reactions was 3.1%; no severe acute adverse RT reactions were observed. CONCLUSION 125I brachytherapy appears to be an effective and safe treatment in the short-term for ACC involving the skull base and could be the preferred treatment for patients with prior RT. Local control with brachytherapy could provide survival benefit even in patients with lung metastasis.
Collapse
Affiliation(s)
- Ning Xu
- Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Lei Zheng
- Associate Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wen-Jie Wu
- Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ming-Wei Huang
- Associate Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jie Zhang
- Professor and Department Head, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jian-Guo Zhang
- Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
| |
Collapse
|
19
|
Abstract
RATIONALE Tracheobronchial adenoid cystic carcinoma (TACC) is a rare malignancy. Surgical resection remains the standard treatment of choice. But it is frequently unresectable due to its local extension. The practicability and safety of hypofractionated radiotherapy (HRT) for TACC remains unknown since most of the TACCs are centrally located. PATIENT CONCERNS A 57-year-old female presented with paroxysmal cough, expectoration, and hemoptysis. DIAGNOSES Computed tomography (CT) scan of the chest revealed a nodule originating from the wall of right primary bronchus, with 1.9*1.2 cm in size. Bronchoscope confirmed the node on the medial wall of the right primary bronchus extending towards the carina, with a close distance of 0.5 cm. Biopsy from the node was considered as adenoid cystic carcinoma (ACC). The clinical stage of the patient was T3N0M0. INTERVENTIONS The patient underwent HRT with a total dose of 60Gy in twelve fractions. OUTCOMES The patient experienced complete remission after HRT. No symptomatic radiation-induced toxicity (≥grade 2) was observed during the follow-up. LESSONS HRT may be a safe and effective modality for inoperable TACC.
Collapse
Affiliation(s)
- Daquan Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | | |
Collapse
|
20
|
Abstract
A report of the results obtained in 194 cases of epithelial tumors of the oral cavity subjected to telecobalt therapy between June 1958 and December 1964 at the Institute of Radiology, University of Milan, and the Radiology Division of the National Cancer Institute. The criteria for establishing whether the treatment was indicated and the principles of selection of cases are specified. In the majority of cases the tumors were no longer circumscribed (T3-T4) and in over half the cases regional lymph node metastases were present when treatment commenced. Thirty-six patients had previously been subjected to radiotherapy or surgery. Telecobalt therapy was given almost exclusively to stationary fields using one or two portals of entry. Tumors of the floor of the mouth were often irradiated through wedges of lead. In 80% of the cases a tumor-dose of between 5000 and 6000 r was given over 6–8 weeks. At the end of treatment the tumor had completely disappeared in 22.7% of the patients, regressed to some extent in 40.6% and was unchanged or had deteriorated in 36.7%. The survival curves show that 2/3 of the patients died within two years of starting treatment; the five-year survival rate was 10.9%. This case-series confirmed that the prognosis is poorer in cases with regional lymph node metastases at the start of treatment and in patients subjected to telecobalt therapy for relapse after radiotherapy or surgery. The results obtained with telecobalt therapy proved to be considerably inferior to those obtained with curietherapy and so the latter is recommended in cancers of the oral cavity whenever it is feasible. Telecobalt therapy may be indicated, mainly as a symptomatic palliative, in very extensive infiltrating tumors adhering to the bone structures and in patients with inoperable lymph node metastases.
Collapse
|
21
|
Dzięciołowska-Baran E, Gawlikowska-Sroka A. Adenoid Cystic Carcinoma of the Cavernous Sinus - Otolaryngological Sequelae of Therapy: Case Report. Adv Exp Med Biol 2018; 1040:23-27. [PMID: 28889233 DOI: 10.1007/5584_2017_95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A 60-year-old woman, otherwise in a good health condition, was first admitted to the hospital with a year-long tingling sensations of the right half of the face, which gradually turned into severe neuralgia corresponding to maxillary (V2) and mandibular (V3) branches of the right trigeminal nerve. MRI scans of the head revealed an unusual hyperplastic or inflammatory changes along the brain base, cavernous sinus extending toward the pterygopalatine fossa, and lateral pterygoid on the right side. Meningioma was suspected and neuralgia was treated conservatively. About 2 years later, due to severe facial and eye pain, the patient underwent decompression of trigeminal nerve roots - Janetta's surgery. The following MRI scans revealed a tumor of cavernous sinus, arousing suspicion of malignancy. Histological specimens obtained after a biopsy and then partial transnasal tumor resection yielded a diagnosis of adenoid cystic carcinoma. The patient was treated with proton radiation therapy. The therapy caused burns in the oropharyngeal soft tissues extending from the oral cavity to the throat and esophagus. The additional adverse effect of the therapy was hypoacusis and a damage to the right cornea. A radiation-induced sinusitis appeared that required surgical intervention. The patient suffered a string of further complications, including pneumonia and a transient kidney failure. In the end, the patient survived. The adenoid carcinoma in the currently 64-year-old woman is visibly reduced, but she still suffers from the trigeminal neuralgia. The patient remains under constant laryngological outpatient care as she requires a periodic cleansing of nasal cavities and hypoacusis monitoring.
Collapse
Affiliation(s)
- Edyta Dzięciołowska-Baran
- Department of Anatomy, Pomeranian Medical University, 72 Powstańców Wlkopolskich Street, 70-111, Szczecin, Poland.
| | - Aleksandra Gawlikowska-Sroka
- Department of Anatomy, Pomeranian Medical University, 72 Powstańców Wlkopolskich Street, 70-111, Szczecin, Poland
| |
Collapse
|
22
|
Ikawa H, Koto M, Takagi R, Ebner DK, Hasegawa A, Naganawa K, Takenouchi T, Nagao T, Nomura T, Shibahara T, Tsuji H, Kamada T. Prognostic factors of adenoid cystic carcinoma of the head and neck in carbon-ion radiotherapy: The impact of histological subtypes. Radiother Oncol 2017; 123:387-393. [PMID: 28528680 DOI: 10.1016/j.radonc.2017.04.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/20/2017] [Accepted: 04/25/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effect of histological subtypes of head and neck adenoid cystic carcinoma (ACC) on the results of carbon-ion radiotherapy (CIRT). MATERIAL AND METHODS Of the 113 patients with ACC who were treated with CIRT between December 2006 and July 2013, 100 patients with identified histological subtypes were enrolled in this study. CIRT at a total dose of 57.6 or 64.0Gy (RBE) was administered in 16 fractions. Histological grading was defined as the presence or absence of a solid growth pattern. RESULTS Median follow-up was 60 months. 5-Year local control (LC), overall survival (OS) and distant metastasis free survival (DMFS) of all patients were 68.6%, 74.8% and 65.7%, respectively. On multivariate analysis, the prescribed dose (p=0.001) and gross tumor volume (p=0.002) were significant independent risk factors for LC. No significant difference for local control of solid/non-solid growth patterns was found (p=0.093). Solid growth pattern was an independent risk factor for both OS (p=0.033) and DMFS (p=0.024). CONCLUSIONS CIRT appears able to locally control solid growth pattern ACC in the head and neck. Improved intervention is needed to extend DMFS and OS.
Collapse
Affiliation(s)
- Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan; Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Japan.
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Ryo Takagi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Daniel K Ebner
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan; Brown University Alpert Medical School, Providence, USA
| | - Azusa Hasegawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kensuke Naganawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Toshinao Takenouchi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | - Takeshi Nomura
- Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Japan
| | - Takahiko Shibahara
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| |
Collapse
|
23
|
Huang YM, Wang Y, Li Y, Liu P, Liu XF, Zhao HW. [Effect of different doses of radiation on human salivary gland adenoid cystic carcinoma cells]. Shanghai Kou Qiang Yi Xue 2016; 25:403-408. [PMID: 27858060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE To explore the effect of different doses of radiation on human salivary gland adenoid cystic carcinoma cells (SACC-83, SACC-LM). METHODS Different doses of radiation (0, 2, 4, 6, 8, 10 Gy) were applied to SACC-83, SACC-LM cells and the cells were continued to culture for 48 h. CCK-8 test, flow cytometry(FCM) and cell scratch experiment were used to observe cell proliferation, apoptosis and cell migration. SPSS19.0 software package was used for data analysis. RESULTS The effect of radiation on SACC-LM cells survival rate, cell apoptosis, heteroploid and cell migration ability were significantly greater than that on SACC-83 cells (P<0.05). In SACC-83 cells, compared with other doses of radiation, 6 Gy of irradiation was the most sensitive on cell survival rate, cell apoptosis, heteroploid and cell migration ability. CONCLUSIONS Radiation sensitivity of SACC-LM was greater than that of SACC-83 cells. With 6 Gy of radiation, changes of biology in SACC-83 cells most significant than other doses of radiation.
Collapse
Affiliation(s)
- Yu-Meng Huang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Chongqing Medical University. Chongqing 401147,China. E-mail:
| | | | | | | | | | | |
Collapse
|
24
|
Murakami M. [Particle beam radiotherapy]. Nihon Jibiinkoka Gakkai Kaiho 2015; 118:1384-1387. [PMID: 26897765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
25
|
Linton OR, Moore MG, Brigance JS, Summerlin DJ, McDonald MW. Proton therapy for head and neck adenoid cystic carcinoma: initial clinical outcomes. Head Neck 2015; 37:117-24. [PMID: 25646551 DOI: 10.1002/hed.23573] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to report outcomes of proton therapy in head and neck adenoid cystic carcinoma. METHODS We conducted a retrospective analysis of 26 patients treated between 2004 and 2012. Twenty patients (77%) had base of skull involvement; 19 (73%) were treated for initial disease and 7 (27%) for recurrent disease. Twenty patients were treated postoperatively, 6 after biopsy alone and 24 had positive margins or gross residual disease.Median dose delivered was 72 Gy (relative biological effectiveness[RBE]). RESULTS Median follow-up was 25 months (range, 7–50 months). The 2-year overall survival was 93% for initial disease course and 57% for recurrent disease (p5.19). The 2-year local control was 95% for initial disease and 86% for recurrent disease (p5.48). The 2-year distant metastatic rate was 25%. Late toxicity of grade 0 or 1 was seen in 17 patients, grade 2 in 5, grade 3 in 2, grade 4 in 1, and grade 5 in 1. CONCLUSION Initial outcomes of proton therapy are encouraging. Longer follow-up is required.
Collapse
|
26
|
Yoon G, Kim HS, Lee YY, Kim TJ, Choi CH, Song SY, Kim BG, Bae DS, Lee JW. Analysis of clinical outcomes of patients with adenoid cystic carcinoma of Bartholin glands. Int J Clin Exp Pathol 2015; 8:5688-5694. [PMID: 26191282 PMCID: PMC4503153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 04/13/2015] [Indexed: 06/04/2023]
Abstract
Adenoid cystic carcinoma of Bartholin glands (BG-ACC) is a rare, slow-growing but a highly aggressive tumor with remarkable capacity for local recurrence and distant metastasis. The purpose of this study was to elucidate our experiences of the diagnosis and treatment of BG-ACC and to analyze the clinical outcomes and prognosis of patients with BG-ACC. A retrospective chart review was performed to assess the demographic information, chief complaints, pathologic features of tumors, primary treatment, and development of local recurrence or distant metastasis, as well as the patient outcome. All patients received surgical excision as the primary treatment, and the diagnosis of BG-ACC was confirmed histopathologically. Three of four patients whose tumors showed pathologic features indicating a high probability of recurrence received adjuvant radiotherapy. These patients did not develop local recurrence, in contrast, one patient who did not receive adjuvant radiotherapy developed local recurrence and distant metastasis on several occasions. All patients who received primary surgical treatment are alive to date. When patients who are more than 40 years of age and who present with symptomatic BG lesions, BG-ACC should be included in the differential diagnosis and biopsy should be performed for histopathologic confirmation. Radical local excision with sufficient negative margins seems to be beneficial for primary treatment. Adjuvant radiotherapy is a reasonable treatment option for patients with high risk factors after surgery or for patients who develop local recurrence.
Collapse
Affiliation(s)
- Gun Yoon
- Department of Gynecology and Obstetrics, Pusan National University Yangsan Hospital, Pusan National University School of MedicineYangsan, Republic of Korea
| | - Hyun-Soo Kim
- Department of Pathology, Severance Hospital, Yonsei University College of MedicineSeoul, Republic of Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Tae-Joong Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Chel Hun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Sang Yong Song
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Duk-Soo Bae
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| |
Collapse
|
27
|
Kadah BA, Niewald M, Papaspyrou G, Dzierma Y, Schneider M, Schick B. Customized individual applicators for endocavitary brachytherapy in patients with cancers of the nasal cavity, sinonasal region and nasopharynx. Eur Arch Otorhinolaryngol 2015; 273:1543-7. [PMID: 25905695 DOI: 10.1007/s00405-015-3636-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/19/2015] [Indexed: 02/03/2023]
Abstract
Brachytherapy has become an established therapeutic regimen for primary, persistent, recurrent and metastatic tumour disease in the head and neck region. This study presents the authors' preliminary experience with intracavitary brachytherapy by means of an individual silicone applicator in the treatment of patients with nasal, sinonasal, orbital and nasopharyngeal cancer. Between January 2001 and January 2013, twenty patients with cancer of the nasal cavity, the paranasal sinuses and nasopharynx underwent surgery and intracavitary brachytherapy with the aid of an individually manufactured silicone applicator in the Department of Otolaryngology, Head and Neck Surgery and in the Department of Radiotherapy and Radiooncology at the Saarland University Medical Center of Homburg, Germany. The tumour was localized in the nasal cavity/paranasal sinuses (15) affecting the orbit twice and the nasopharynx (5). There were 14 patients with squamous cell carcinoma, 2 patients with mixed tumours and one patient with adenocarcinoma, adenoid cystic carcinoma, mucosal melanoma or plasmocytoma. The majority of the patients presented with advanced disease (T3 or T4 tumours). In 18/20 patients, brachytherapy was performed as a boost technique, in the remaining two solely because of a previous radiation series. All surgical interventions were performed endonasally. Three to six weeks after surgery, a cast of the nasal cavity was created under general anaesthesia. Subsequently, an individual brachytherapy silicon applicator with two to four plastic tubes was manufactured. The radiation therapy was applied using the Ir-192 high-dose-rate-afterloading method (total dose 10-20 Gy) in two to five sessions, additionally in 18/20 patients a percutaneous radiotherapy with a total dose of 30-60 Gy was applied. After a mean duration of follow-up of 2 years, 7/20 patients experienced a local progression, 5/19 a regional recurrence in the neck nodes and 4/19 distant metastases. The 2-year survival was 57.3 %. No serious complications were reported. The silicone applicator was well tolerated by all patients. Because of the complexity of the sinonasal anatomy with the finding of mainly advanced tumours, the presented individual silicone brachytherapy applicator has proven to be useful and meaningful for endocavitary brachytherapy of malignancies of the nasal cavities, paranasal sinuses and nasopharynx.
Collapse
Affiliation(s)
- Basel Al Kadah
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg/Saar, Germany.
| | - Marcus Niewald
- Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Homburg/Saar, Germany
| | - George Papaspyrou
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg/Saar, Germany
| | - Yvonne Dzierma
- Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Mathias Schneider
- Institute for Epithetics and Anaplastology Schneider, Zweibrücken, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg/Saar, Germany
| |
Collapse
|
28
|
Abstract
We report the case of a 63-year-old patient suffering from a nasopharyngeal adenoid cystic carcinoma. She presented with increased oral secretion and pharyngeal irritation, Horner's syndrome, and trigeminal neuralgia. Magnetic resonance imaging scans revealed a tumor of the nasopharyngeal space invading the right cranial base. Lymph node metastases were clinically excluded. The histological sample confirmed an adenoid cystic carcinoma, which was therapeutically treated with adequate radiotherapy. Based on the presented case report and a review of the literature, we discuss the diagnosis and treatment of adenoid cystic carcinomas of the nasopharynx.
Collapse
Affiliation(s)
- I Karapantzos
- Klinik für Hals-, Nasen-, Ohrenheilkunde, Marienhospital, Böheimstrasse 37, 70199 Stuttgart
| | | | | | | | | |
Collapse
|
29
|
Chung MP, Tang C, Chan C, Hara WY, Loo BW, Kaplan MJ, Fischbein N, Le QT, Chang DT. Radiotherapy for nonadenoid cystic carcinomas of major salivary glands. Am J Otolaryngol 2013; 34:425-30. [PMID: 23583094 DOI: 10.1016/j.amjoto.2013.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 03/10/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To report outcomes in patients treated with postoperative radiotherapy for nonadenoid cystic carcinomas of the major salivary glands. MATERIALS AND METHODS From 1998-2011, 37 patients with nonadenoid cystic carcinomas of the major salivary gland underwent postoperative radiotherapy. The median radiation dose was 60 Gy (range, 45-70 Gy). TNM distribution included T1-2 (n=16, 44%), T3-T4 (n=21, 56%), N0 (n=19, 51%), and N+ (n=18, 49%). Histologies included adenocarcinoma (n=13, 35%), squamous cell carcinoma (n=8, 22%), mucoepidermoid carcinoma (n=8, 22%), and other (n=8, 21%). Median follow-up was 4.7 years for all patients (range, 0.3-14.1 years) and 5.0 years for living patients (range, 1.2-12.2 years). RESULTS Five-year local-regional control, overall survival (OS), and cancer-specific survival (CSS) were 97%, 76%, and 84%. On univariate analysis, OS was significantly worse for patients ≥65 years old (p=0.04). CSS was significantly worse for positive perineural invasion (p=0.02), extraparenchymal extension (p=0.04), and in patients who received no chemotherapy (p=0.02). Doses >60 Gy was significantly worse for OS (p=0.003) and CSS (p=0.003), although these patients had higher TNM (>T2, p=0.01) and trended towards a higher rate of extraparenchymal extension (p=0.08). Four patients (11%) developed ≥grade 2 toxicities; 3 patients developed early toxicities and one patient developed late toxicities. CONCLUSIONS Radiotherapy for salivary gland tumors provides excellent local-regional control when combined with surgery. Distant metastasis is the predominant pattern of failure, although chemotherapy seemed to improve cancer-specific survival.
Collapse
Affiliation(s)
- Melody P Chung
- Department of Radiation Oncology, Stanford University, Stanford, CA 94305, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Rouzé S, Flécher E, de Latour B, Meunier C, Sellin M, Lena H, Verhoye JP. [Tracheal adenoid cystic carcinoma treated by complete carinal reconstruction with the help of an ECMO: about a case]. Rev Pneumol Clin 2013; 69:144-148. [PMID: 23597633 DOI: 10.1016/j.pneumo.2013.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 02/26/2013] [Accepted: 02/28/2013] [Indexed: 06/02/2023]
Abstract
Primitive tumors of the trachea are rare, accounting for 0.1% of the airway tumors. Cystic adenoid carcinoma (or cylindroma) represents the second most frequent type of tracheal cancers. Histologically speaking, this tumor type is divided in three patterns: cribriform, tubular and solid; it presents a slow growth, perineural invasion and potential local recurrence and metastasis. We presented herein the case of a 56-year-old female suffering from a cystic adenoid carcinoma of the low trachea. She has been treated by carinal resection with negative airway margin and complete reconstruction, with the help of an extra corporeal membrane oxygenation (ECMO).
Collapse
Affiliation(s)
- S Rouzé
- Département de chirurgie thoracique et cardiovasculaire, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
| | | | | | | | | | | | | |
Collapse
|
31
|
Abstract
OBJECTIVES Two cases of adenoid cystic carcinoma (ACC) of the larynx were treated with chemoradiotherapy (CRT) for organ preservation. We reviewed case series and current literature to contrast the potential role of primary CRT as an organ-sparing modality with standard laryngectomy and radiotherapy in patients with laryngeal ACC. METHODS Two treatment-naïve patients with laryngeal ACC treated at Dana-Farber Cancer Institute between 2002 and 2007 were identified. Both patients were offered standard laryngectomy followed by adjuvant radiotherapy or organ-sparing treatment modality. RESULTS Both patients were males, aged 57 and 73. The patients completed a course of combined chemoradiotherapy with weekly carboplatin and paclitaxel and 7-8 weeks of radiotherapy to a total dose of 6,600 and 7,000 cGy over 50 and 57 days, respectively. There were no treatment breaks or delays because of toxicity. The major toxicities reported by both patients, as anticipated, were Grade 3 mucositis, desquamative dermatitis, and severe dysphagia, all of which resolved. Both patients are alive with local regional control and functional larynx; one at 112+ months with pulmonary metastases at 54 months, and the other disease free at 60+ months. CONCLUSIONS Definitive chemoradiation with weekly carboplatin and paclitaxel may be a potential alternative to the current standard of surgery and radiation for patients with locally advanced laryngeal ACC who request an organ-sparing approach. In this group of patients, salvage laryngectomy may be reserved for those who are locally recurrent or chemoradiotherapy resistant. Although CRT provided long-term local regional control in our two patients, there are evident limitations in obtaining evidence for a determination of treatment of rare diseases. This report provides support for following an organ preservation plan in selected patients.
Collapse
Affiliation(s)
- Krzysztof J Misiukiewicz
- Department of Medicine, Hematology and Medical Oncology, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
| | | | | | | | | | | |
Collapse
|
32
|
Agolli L, Osti MF, Armosini V, De Sanctis V, Valeriani M, Enrici RM. Adenoid cystic carcinoma of Bartholin's gland receiving adjuvant radiation therapy: case report. EUR J GYNAECOL ONCOL 2013; 34:487-488. [PMID: 24475591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Adenoid cystic carcinoma (ACC) of Bartholin's gland is an extremely rare tumor of the female genital tract, representing about 5%-15% of Bartholin's gland malignancies. Approximately 80 cases have been reported in the literature. The authors describe the case of a 54-year-old woman with locally advanced ACC of Bartholin's gland treated with surgery and adjuvant radiotherapy (RT). She underwent radical hemivulvectomy associated with ipsilateral inguinal and femoral lymph node dissection. Subsequently, she received postoperative three-dimensional conformal RT. Total dose prescribed was 56 Gy in 28 fractions of two Gy each. After 20 months of follow up, there was no evidence of local failure or distant progression.
Collapse
Affiliation(s)
- L Agolli
- Institute of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University, Rom, Italy.
| | - M Falchetto Osti
- Institute of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University, Rom, Italy
| | - V Armosini
- Institute of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University, Rom, Italy
| | - V De Sanctis
- Institute of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University, Rom, Italy
| | - M Valeriani
- Institute of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University, Rom, Italy
| | - R Maurizi Enrici
- Institute of Radiation Oncology, Sant'Andrea Hospital, "Sapienza" University, Rom, Italy
| |
Collapse
|
33
|
Abstract
Retraction of the lower eyelid can be consequence of medical and surgical conditions. Various kinds of allotransplants and biomaterial have been used to correct it; we report on the surgical correction of lower lid retraction with a decellularized porcine derived membrane (Tarsys(®)). A 49-year-old patient with a history of adenoid cystic carcinoma in the pterygo-palatine fossa, requiring extensive surgery and repeated radiotherapy, presented with 6 mm lagophthalmus and exposure keratopathy secondary to facial nerve palsy. The lower lid malposition was corrected with a Tarsys(®) implant. Three months after surgery no lagophthalmos was present and substantial relief of signs and symptoms of ocular surface disease and good symmetry between right and left eye was achieved. If general condition or morbidity in potential donor sites hamper harvesting autologous graft material to support the lower lid, bioengineered xenografts can be used successfully to correct eyelid malpositions such as lower lid retraction.
Collapse
Affiliation(s)
- Maria Borrelli
- Department of Ophthalmology, University of Düsseldorf, Düsseldorf, Germany.
| | | | | | | |
Collapse
|
34
|
Veeratterapillay R, Veeratterapillay S, Ward E, Khout H, Fasih T. Adenoid cystic carcinoma of the breast: case report and review of literature. Ann R Coll Surg Engl 2012; 94:e137-8. [PMID: 22613278 PMCID: PMC5827221 DOI: 10.1308/003588412x13171221499829] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2011] [Indexed: 11/22/2022] Open
Abstract
We report the case of a patient who presented with a painful breast lump that turned out to be an adenoid cystic carcinoma of the breast. The literature is reviewed, highlighting the good prognosis associated with this rare condition and the current preferred treatment modalities.
Collapse
|
35
|
Samant S, van den Brekel MW, Kies MS, Wan J, Robbins KT, Rosenthal DI, Rasch C, Weber RS. Concurrent chemoradiation for adenoid cystic carcinoma of the head and neck. Head Neck 2011; 34:1263-8. [PMID: 22083968 DOI: 10.1002/hed.21905] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2011] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND We performed a retrospective review of patients with nonresected head and neck adenoid cystic carcinoma (ACC) treated with concurrent chemoradiation. METHODS Sixteen patients (nasopharynx 7, oropharynx 4, trachea 3, oral and nasal cavity 1 each) were treated at 3 tertiary care centers. Six patients received intraarterial cisplatin and 10 received intravenous cisplatin or carboplatin concurrently with radiation. RESULTS Thirteen patients are alive, 7 without signs of disease with a median follow-up of 61 months. Tumor progression was noted in 8 patients (50%) (distant metastasis in 5 patients and local tumor progression in 3 patients) with a median time to progression of 25 months (range, 4-52 months). Overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) rates at 5 years were 87%, 39%, and 61%, respectively. CONCLUSION Concurrent chemoradiation is a feasible treatment option and may lead to sustained locoregional tumor control in patients with nonresected ACC of the head and neck.
Collapse
Affiliation(s)
- Sandeep Samant
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Droussi H, Ettalbi S, Ouahbi S, Soussou M, Boukind S. [Adenoid cystic carcinoma of the scalp]. Ann Dermatol Venereol 2011; 138:418-21. [PMID: 21570568 DOI: 10.1016/j.annder.2011.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 01/30/2011] [Accepted: 02/21/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few cases of adenoid cystic carcinoma of the scalp have been described in the literature. Herein, we report a new case illustrating the difficulties of diagnosis and treatment of this rare form of tumour. CASE REPORT A 49-year-old man consulted for a large ulcerated scalp tumour. The biopsy sample exhibited an aspect of cystic adenoid carcinoma. Bone invasion had occurred. Extremely wide surgical excision was carried out, extending down to the dura mater, with covering by means of a frontal flap with left temporal pedicle. Since the edges of the resection were also tumoural, postoperative radiotherapy at 56Gy was given. Twelve months later, the patient was still in remission. DISCUSSION The standard treatment for adenoid cystic carcinoma is complete surgical excision but this approach may be complicated by difficulties relating to the degree of tumour spread or to the anatomical site. Postoperative radiotherapy appears to improve local control, as illustrated by our case.
Collapse
Affiliation(s)
- H Droussi
- Unité de chirurgie plastique, réparatrice et brûlés, CHU Mohammed VI, Marrakech, Morocco.
| | | | | | | | | |
Collapse
|
37
|
Liu WS, Xu ZG, Gao L, Tang PZ, Xu GZ, Zhang GF. [Adenoid cystic carcinoma of maxillary sinus: diagnosis, treatment and prognostic factors]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46:402-407. [PMID: 21781563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To study the clinical characters, the outcomes of treatments and the factors affecting long-term treatment results of adenoid cystic carcinoma (ACC) of the maxillary sinus. METHODS The clinical data of 80 patients with ACC of the maxillary sinus treated initially were analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression. RESULTS The 5-, 10- and 15-year cumulative overall survival rates were 65.2%, 37.1%, 26.3% respectively and 5-, 10-, and 15-year disease-free survival rates 50.7%, 30.7% and 24.5% respectively. The 5-, 10- and 15-year cumulative local control rates were 68.5%, 47.3% and 47.3% respectively and the cumulative distant metastasis rate were 32.8%, 48.8% and 48.8% respectively. Prognostic factors affecting survival included T stage, pathologic grade and the modes of treatment (P < 0.05). Patients with combined therapy composed of surgery and radiation had a better local control, compared with surgery or radiation alone (χ(2) = 18.33, P < 0.01), and surgery combined with postoperative radiation was prior to preoperative radiation combined with surgery (χ(2) = 6.64, P < 0.05). Patients treated with surgery combined with preoperative radiation, either with doses of ≥ 60 Gy or with negative margins, had a better local control, compared with doses < 60 Gy and with positive margins (χ(2) = 5.06, P < 0.05). The most of patients (62.8%) died of local recurrence. CONCLUSIONS The most of failure was due to recurrence. Combined therapy composed of surgery and radiation improves the local control and survival in patients with ACC of the maxillary sinus, compared with surgery or radiation alone. Surgery combined with postoperative radiation provides the best overall survival and local control and should be the first choice of treatments.
Collapse
Affiliation(s)
- Wen-sheng Liu
- Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100021, China.
| | | | | | | | | | | |
Collapse
|
38
|
Kharchenko VP, Pan'shin GA, Gvarishvili AA. [Radical radiotherapy of primary cancer of the trachea]. Vopr Onkol 2011; 57:359-365. [PMID: 21882608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The paper deals with the importance of treatment of primary cancer of the trachea and, in particular, the experience of the Center in using radical therapy for inoperable squamous cell tumors and adenoid cystic carcinoma. An original system of tumor staging developed at the Center draws on international classifications (TNIVI) and methods of radiotherapy depending on tumor localization. It is shown that tracheal malignancies, especially adenoid cystic carcinomas, are characterized by relatively high radiosensitivity.
Collapse
|
39
|
Ooi EH, Marchie A, Witterick IJ. Adenoid cystic carcinoma of the pterygopalatine fossa presenting as facial pain. J Otolaryngol Head Neck Surg 2010; 39:E37-E38. [PMID: 20828499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- Eng H Ooi
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Mount Sinai Hospital, Toronto, ON, Canada.
| | | | | |
Collapse
|
40
|
Hou JL, Wu LY, Zhang HT, Li N, Yu GZ. [Clinicopathological characteristics of six patients with adenoid cystic carcinoma of the Bartholin gland]. Zhonghua Zhong Liu Za Zhi 2010; 32:290-293. [PMID: 20510082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To evaluate the clinicopathological characteristics and treatment of adenoid cystic carcinoma of the Bartholin gland. METHODS The clinicopathological data of six patients with adenoid cystic carcinoma of the Bartholin gland were retrospectively analyzed. The median age was 40.8 years (range 30 to 54 years). Surgery was the primary treatment. Simple vulvar tumor resection was performed in 1 patient. Four cases underwent radical vulvectomy with bilateral inguinal lymph node dissection and 1 case underwent wide local excision of the vulva with bilateral inguinal lymph node biopsy. Two cases with high risk factors received postoperative radiotherapy. RESULTS All patients had definite pathological diagnosis. Cribriform arrangement of tubules and gland-like elements and infiltration of perineural spaces were two main microscopic features of this type of tumor. The pathological examination after surgery revealed that two patients had positive surgical margins, one had negative margin, 1 adjacent to the tumor and 1 unknown; 5 cases had negative inguinal lymph nodes and 1 unknown. All the 6 patients were followed-up. Recurrence developed in 4 cases including 3 with both local recurrence and lung metastasis, and one had lung metastasis only. One patient died of lung metastasis and her total survival period was 135 months. The other 3 recurrent patients survived with tumor and the total survival period was 241, 128 and 103 months, respectively. Two cases without recurrence survived 8 and 121 months, respectively. CONCLUSION Adenoid cystic carcinoma of the Bartholin gland is a slow growing but locally very aggressive neoplasm with a high capacity for local recurrence and lung metastasis. Surgery is the most common and useful treatment. Radiation is a choice of treatment for patients with high risk factors after surgery such as positive surgical margin, deep local invasion and infiltration of perineural spaces or for recurrent patients without opportunity of excision.
Collapse
Affiliation(s)
- Jin-lin Hou
- Department of Gynecological Oncology, Cancer Hospital, Chinese Academy of Medicalsciences and Peking Union Medical College, Beijing 100021, China
| | | | | | | | | |
Collapse
|
41
|
Huang MW, Tong D, Zhang J, Zhang HZ, Zhang JG, Yu GY. [The technic and dose evaluation of postoperative (125)I radioactive seeds brachytherapy for malignant tumors of maxilla]. Zhonghua Kou Qiang Yi Xue Za Zhi 2009; 44:517-519. [PMID: 20079247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate the technique and effect of treating malignant tumors of maxilla with postoperative brachytherapy by digital model obturators containing (125)I radioactive seeds. METHODS Four patients with adnoid cystic carcinomas and two with squamous cell carcinomas in the maxilla were included in this study. All patients accepted (125)I seeds implantation after operation, and wore digital model obturators containing (125)I seeds. The prescription dose was 80 Gy. All patients were followed up every 2 months after treatment. RESULTS The total number of seeds used in these six patients was 189, and 105 seeds were contained in obturators. Radioactive seeds and doses distributed very well as designed in all patients. No tumors recurred after follow up of 12-16 months and there were no severe complications. CONCLUSIONS It's an effective way to treat malignant tumors with positive excision margin in the maxilla by brachytherapy using digital model obturators which contain (125)I radioactive seeds.
Collapse
Affiliation(s)
- Ming-wei Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | | | | | | | | | | |
Collapse
|
42
|
Nomoto S, Shioyama Y, Ohga S, Nonoshita T, Ohnishi K, Atsumi K, Terashima K, Nakashima T, Nakamura K, Hirata H, Honda H. Preliminary results of radiation therapy for locally advanced or recurrent adenoid cystic carcinomas of the head and neck using combined conventional radiation therapy and hypofractionated inverse planned stereotactic radiation therapy. Fukuoka Igaku Zasshi 2009; 100:59-66. [PMID: 19455976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE To investigate the clinical outcomes and feasibility of combined conventional radiation therapy (RT) and hypofractionated inverse planned stereotactic radiation therapy (SRT) for locally advanced or recurrent adenoid cystic carcinomas (ACCs) of the head and neck. PATIENTS AND METHODS Five patients with ACCs of the head and neck were treated with combined conventional RT and inverse planned SRT. Radiation doses of 40 to 50 Gy were delivered with 20 to 25 fractions using conventional RT, and then an additional 20 to 25 Gy was delivered by 4 to 5 fractions of SRT. RESULTS Median follow-up was 12 months. Local control was obtained in all 5 patients, PR in 2 patients and SD in 3 patients. According to the Radiation Therapy Oncology Group (RTOG) late-radiation morbidity scoring criteria, adverse effects included Grade 2 xerostomia in 1 patient, Grade 2 trismus in 1 patient, and Grade 4 mucosal ulceration in 1 patient. CONCLUSION Combined treatment with conventional RT and hypofractionated inverse planned SRT may be effective for short-term local control in patients with locally advanced or recurrent ACCs. Further evaluation is needed for long-term follow-up.
Collapse
Affiliation(s)
- Satoshi Nomoto
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Sbitti Y, Kadiri H, Fetohi M, Elghissassi I, M'rabti H, Boutayeb S, Ichou M, Boussen H, Errihani H. [Primary adenoid cystic carcinoma in breast]. Cancer Radiother 2008; 13:65-8. [PMID: 19097926 DOI: 10.1016/j.canrad.2008.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 10/02/2008] [Accepted: 10/07/2008] [Indexed: 11/19/2022]
Abstract
Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm. We report two observations occurring in female patients, 54 and 65 years old, who consulted for a mastodynia. Clinical examination showed limited painful breast nodules. On ultrasound and mammography they are well-limited bulky mass without microcalcifications. Diagnosis was based on final histopathological exam completed by immunohistochemistry or after slides review. The two patients were treated by mammectomy plus adjuvant radiotherapy and remain alive in remission with a follow-up of 29 and 36 months.
Collapse
Affiliation(s)
- Y Sbitti
- Department d'oncologie médicale, institut national d'oncologie, Rabat, Maroc.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Agarwal JP, Jain S, Gupta T, Tiwari M, Laskar SG, Dinshaw KA, Chaturvedi P, D'cruz AK, Shrivastava SK. Intraoral adenoid cystic carcinoma: prognostic factors and outcome. Oral Oncol 2008; 44:986-93. [PMID: 18329324 DOI: 10.1016/j.oraloncology.2008.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Revised: 12/21/2007] [Accepted: 01/03/2008] [Indexed: 12/15/2022]
Abstract
Intraoral (oral cavity and oropharynx) adenoid cystic carcinomas are uncommon cancers characterized by slow evolution, protracted clinical course, multiple and/or delayed recurrences, and late distant metastases. The molecular biology behind this enigmatic disease remains poorly characterized. To analyze and correlate prognostic factors with outcome in intraoral adenoid cystic carcinoma. Medical records of 76 patients with intraoral adenoid cystic carcinoma treated with definitive loco-regional therapy at the institute between 1992 and 2004 were retrospectively reviewed and analyzed.Majority (85.5%) of the patients had advanced stage disease. Seventy-four patients underwent surgery, of which 51 (68.9%) received adjuvant radiotherapy. The median dose of radiation was 56 Gy (range 44-66 Gy). Two patients with medical co-morbidities received radical radiotherapy. Perineural invasion, margin positivity and nodal positivity were present in 24 (32.4%); 27 (36.4%); and 15 (19.7%) patients, respectively. Ten (13.1%) patients developed local recurrence and 6 (7.8%) distant metastases. With a median follow-up of 20 months (range 1-137 months), the 5-year Kaplan-Meier estimates of local control and disease-free survival were 57.9% and 47.1%, respectively. On uni-variate analysis, perineural invasion (p=0.003), oropharyngeal primary (p=0.033), and advanced T-stage (p=0.047) were associated with increased local recurrences. Perineural invasion (p=0.05) and primary site (p=0.042) also predicted disease-free survival. On multivariate analysis, both perineural invasion and primary site retained significance for local control (p=0.007, p=0.011) and disease-free survival (p=0.018, p=0.014), respectively. Intraoral adenoid cystic carcinoma is an uncommon disease with an enigmatic clinical course. Perineural invasion, site of primary, and T-stage significantly impact upon local control and disease-free survival. The role of adjuvant radiotherapy remains controversial. Larger prospective studies with mature follow-up are needed to define the optimal treatment of intraoral adenoid cystic carcinoma.
Collapse
Affiliation(s)
- J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Dr. Ernest Borges Road, Parel, Mumbai 400 012, Maharashtra, India.
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Aydin O, Ustündağ E, Işeri M, Erçin C. Laryngeal adenoid cystic carcinoma in an adolescent. Kulak Burun Bogaz Ihtis Derg 2008; 18:319-322. [PMID: 19155680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Malignant tumors of the larynx are extremely rare in children and adolescents. Adenoid cystic carcinoma accounts for less than 1% of all malignant tumors in the larynx. We presented a 16-year-old girl with subglottic adenoid cystic carcinoma, whose symptoms of prolonged and exacerbating dyspnea had been attributed to asthma at another medical center. Indirect flexible and rigid laryngoscopy revealed a smooth mass in the subglottic region occupying 80% of the airway passage. The lesion was also confirmed by both CT and MRI. There was no lymphadenopathy in the neck. The patient was successfully treated by surgery and postoperative radiotherapy. Pathological staging was T4N0M0 according to the AJCC, 2003. During six years of follow-up, there was no evidence for local recurrence or regional and distant metastasis.
Collapse
Affiliation(s)
- Omer Aydin
- Department of Otolaryngology, Medicine Faculty of Kocaeli University, Kocaeli, Turkey
| | | | | | | |
Collapse
|
46
|
Arriola-Villalobos P, Donate-López J, Calvo-González C, Reche-Frutos J, Alejandre-Alba N, Díaz-Valle D. Intravitreal bevacizumab (Avastin) for radiation retinopathy neovascularization. Acta Ophthalmol 2008; 86:115-6. [PMID: 17680838 DOI: 10.1111/j.1600-0420.2007.00977.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Abstract
BACKGROUND The relative importance of surgery within multimodality regimens commonly used to treat advanced sinonasal malignancies remains unknown. METHODS One hundred two patients with locally advanced sinonasal cancers treated with proton beam radiation therapy with or without surgery were retrospectively reviewed. Extent of surgery and outcome variables of local control, disease-free survival, and overall survival were evaluated. Patterns of failure were also assessed. RESULTS Extent of surgery correlated with disease-free survival and overall survival rates. Local control rate, however, was independent of the degree of surgical resection achieved. Overall, treatment failure most commonly resulted from distant metastases, which occurred in 30% of patients and also correlated with extent of surgical resection. Tumor type-specific outcomes reveal differences associated with the extent of surgery achieved. CONCLUSION High-dose radiotherapy with proton beam resulted in excellent local control rates in patients with locally advanced sinonasal cancer, irrespective of the extent of surgery. Complete resection, however, was predictive of improved disease-free survival and decreased rate of distant metastasis.
Collapse
Affiliation(s)
- Vicente A Resto
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | | | | | | |
Collapse
|
48
|
Chen AM, Daly ME, Bucci MK, Xia P, Akazawa C, Quivey JM, Weinberg V, Garcia J, Lee NY, Kaplan MJ, El-Sayed I, Eisele DW, Fu KK, Phillips TL. Carcinomas of the Paranasal Sinuses and Nasal Cavity Treated With Radiotherapy at a Single Institution Over Five Decades: Are We Making Improvement? Int J Radiat Oncol Biol Phys 2007; 69:141-7. [PMID: 17459609 DOI: 10.1016/j.ijrobp.2007.02.031] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Revised: 01/31/2007] [Accepted: 02/21/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare clinical outcomes of patients with carcinomas of the paranasal sinuses and nasal cavity according to decade of radiation treatment. METHODS AND MATERIALS Between 1960 and 2005, 127 patients with sinonasal carcinoma underwent radiotherapy with planning and delivery techniques available at the time of treatment. Fifty-nine patients were treated by conventional radiotherapy; 45 patients by three-dimensional conformal radiotherapy; and 23 patients by intensity-modulated radiotherapy. Eighty-two patients (65%) were treated with radiotherapy after gross total tumor resection. Nineteen patients (15%) received chemotherapy. The most common histology was squamous cell carcinoma (83 patients). RESULTS The 5-year estimates of overall survival, local control, and disease-free survival for the entire patient population were 52%, 62%, and 54%, respectively. There were no significant differences in any of these endpoints with respect to decade of treatment or radiotherapy technique (p > 0.05, for all). The 5-year overall survival rate for patients treated in the 1960s, 1970s, 1980s, 1990s, and 2000s was 46%, 56%, 51%, 53%, and 49%, respectively (p = 0.23). The observed incidence of severe (Grade 3 or 4) late toxicity was 53%, 45%, 39%, 28%, and 16% among patients treated in the 1960s, 1970s, 1980s, 1990s, and 2000s, respectively (p = 0.01). CONCLUSION Although we did not detect improvements in disease control or overall survival for patients treated over time, the incidence of complications has significantly declined, thereby resulting in an improved therapeutic ratio for patients with carcinomas of the paranasal sinuses and nasal cavity.
Collapse
MESH Headings
- Adenocarcinoma/mortality
- Adenocarcinoma/radiotherapy
- Adenocarcinoma/surgery
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Adenoid Cystic/mortality
- Carcinoma, Adenoid Cystic/radiotherapy
- Carcinoma, Adenoid Cystic/surgery
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Disease-Free Survival
- Female
- Humans
- Male
- Middle Aged
- Nasal Cavity
- Neoplasm Recurrence, Local
- Nose Neoplasms/mortality
- Nose Neoplasms/radiotherapy
- Nose Neoplasms/surgery
- Paranasal Sinus Neoplasms/mortality
- Paranasal Sinus Neoplasms/radiotherapy
- Paranasal Sinus Neoplasms/surgery
- Radiation Injuries/prevention & control
- Radiotherapy/adverse effects
- Radiotherapy/trends
- Radiotherapy, Conformal/adverse effects
- Radiotherapy, Intensity-Modulated/adverse effects
- Time Factors
- Treatment Outcome
Collapse
Affiliation(s)
- Allen M Chen
- Department of Radiation Oncology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Soprani F, Armaroli V, Venturini A, Emiliani E, Casolino D. A rare case of adenoid cystic carcinoma of the nasopharynx manifesting as Horner's syndrome: discussion and review of the literature. Acta Otorhinolaryngol Ital 2007; 27:216-219. [PMID: 17957854 PMCID: PMC2640026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Accepted: 01/06/2007] [Indexed: 05/25/2023]
Abstract
Adenoid cystic carcinoma is a malignant tumour involving the salivary glands, rarely developing in the nasopharynx. The biological behaviour of adenoid cystic carcinoma is characterized by slow growth rate, high tendency to local recurrence and metastatic spread. Its histological features are particularly important for prognostic prediction: solid pattern has the worst outcome. Initial presentation of nasopharyngeal adenoid cystic carcinoma with paresis of cranial nerves and Horner's syndrome is infrequent. The Authors present a case of a rare adenoid cystic carcinoma of the nasopharynx, at admission with Horner's syndrome, in a 66-year-old male. Magnetic resonance imaging showed an expansive submucosal lesion of the nasopharynx involving the para-pharyngeal space, tensor and levator veli palati muscles and the apex of petrous bone. Positron emission tomography excluded distant metastasis. Definitive histopathological examination revealed an adenoid cystic carcinoma with mixed cribriform and solid pattern. The patient was treated exclusively with radiotherapy (70 Gy) in 35 fractions with partial reduction of the neoplastic mass.
Collapse
Affiliation(s)
- F Soprani
- Department of Otolaryngology, Head and Neck Surgery, Santa Maria delle Croci Hospital, Ravenna, Italy.
| | | | | | | | | |
Collapse
|
50
|
Kaszuba SM, Zafereo ME, Rosenthal DI, El-Naggar AK, Weber RS. Effect of initial treatment on disease outcome for patients with submandibular gland carcinoma. ACTA ACUST UNITED AC 2007; 133:546-50. [PMID: 17576904 DOI: 10.1001/archotol.133.6.546] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To elucidate the effect on outcome of initial surgical enucleation with or without definitive surgical resection and radiation therapy for patients with submandibular gland carcinoma. DESIGN Retrospective clinicopathological review. SETTING Tertiary referral center. PATIENTS Eighty-seven consecutive patients (mean follow-up, 8.7 years) with primary submandibular gland carcinoma. MAIN OUTCOME MEASURES Review of proven cases of primary carcinomas of the submandibular gland treated at our institution during a 33-year period to determine the effect of the type of biopsy and subsequent treatment on locoregional disease control, disease-specific survival, and overall survival. RESULTS There was no statistically significant difference in locoregional disease control, disease-specific survival, or overall survival between patients undergoing enucleation of the gland vs patients undergoing enucleation of the gland followed by definitive surgical resection before any radiation therapy. There were no locoregional recurrences among 28 patients treated with enucleation and radiation therapy, compared with 3 locoregional recurrences (7%) among 42 patients treated with enucleation followed by definitive surgical resection before any radiation therapy. Twenty-nine (69%) of 42 patients undergoing a second surgical procedure had evidence of residual carcinoma in the final surgical specimen. CONCLUSIONS En bloc surgical resection followed by radiation therapy remains the standard treatment for patients with submandibular gland carcinoma. Patients without clinical and radiographic evidence of disease after enucleation may be adequately treated with subsequent radiation therapy. Definitive surgical resection remains the treatment of choice for patients with clinical or radiographic evidence of disease after enucleation of the gland.
Collapse
Affiliation(s)
- Scott M Kaszuba
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 441, Houston, TX 77030, USA
| | | | | | | | | |
Collapse
|