Role of postoperative radiotherapy in resected adenoid cystic carcinoma of the head and neck

Radiation Oncology

Research

Eun Chang Choi¹  Se-Heon Kim¹  Sun Och Yoon²  Andrew Jihoon Yang³  Seo Hee Choi⁴  Chang Geol Lee⁵  Ki Chang Keum⁵  Hye Ryun Kim⁶  Min Hee Hong⁶ 

[1] Department of Otorhinolaryngology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea;Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea;Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-Do, Korea;Department of Inpatient Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-Do, Korea;Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-Do, Korea;Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea;Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea;Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea;

关键词: Adenoid cystic carcinoma;    Postoperative radiotherapy;    Radiation;    Prognosis;    Local recurrence;   

DOI  :  10.1186/s13014-022-02165-5

 received in 2022-09-15, accepted in 2022-11-21,  发布年份 2022

来源: Springer

【 摘 要 】

PurposeAlthough postoperative radiotherapy (PORT) is demonstrably effective in local control of head and neck adenoid cystic carcinoma (HNACC), its application is controversial and the subset of patients who would benefit most from PORT is unknown. Herein, we analyzed the data of HNACC patients to clarify the role of PORT.MethodsWe retrospectively reviewed 187 patients with nonmetastatic HNACC who underwent surgical resection between 2005 and 2019. The study endpoints were locoregional failure-free survival (LRFFS), progression-free survival (PFS), and overall survival (OS). Subgroup analysis and recursive partitioning analysis (RPA) were performed to identify patients most likely to benefit from PORT.ResultsWith a median follow-up of 84.7 months, the 5-year LRFFS, PFS, and OS were 70.0%, 52.6%, and 86.4%, respectively. Survival was significantly shorter in patients who experienced local failure than in those who did not (5-year OS: 88.1% vs. 80.5%, P = 0.001). The local failure rate was significantly lower in patients who underwent PORT (16.9% vs. 31.0%, P = 0.021), despite the high frequency of adverse factors. Especially, significant decreases in local failure and similar OS rates could be obtained after PORT among patients with positive margins, T2-4 stage disease, and minor salivary gland tumors. The RPA model for PFS categorized patients into four groups according to three prognostic factors (T-stage, location, and sex). The RPA model for LRFFS and OS suggested three groups based on two factors (T-stage, margin for LRFFS; T-stage, grade 3 for OS).ConclusionPORT could prevent dismal survival, while significantly reducing local failures in high-risk HNACC patients.

【 授权许可】

CC BY   
© The Author(s) 2022

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