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Multicenter Study of Carbon-Ion Radiation Therapy for Adenoid Cystic Carcinoma of the Head and Neck: Subanalysis of the Japan Carbon-Ion Radiation Oncology Study Group (J-CROS) Study (1402 HN)
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Summary
Adenoid cystic carcinomas of the head and neck are rare, comparatively radioresistant tumors. In this large cohort of a retrospective multicenter
study, we evaluated the effectiveness and safety of carbon-ion radiation therapy
in 289 patients with adenoid cystic carcinoma of the head and neck. The physical and biological characteristics of carbon-ions allowed delivery
of localized high tumor doses, resulting in good local control and overall survival
with tolerable treatmentrelated toxicity.
\nPurpose: To retrospectively analyze the treatment outcomes of carbon-ion radiation
therapy for adenoid cystic carcinoma (ACC) of the head and neck at 4 active
carbon-ion facilities in Japan.
Methods and Materials: A total of 289 patients who underwent carbon-ion radiation
therapy for histology-proven ACC of the head and neck at 4 institutions in Japan between
November 2003 and December 2014 were included in this study.
Results: Median patient age was 58 years (range, 12-83 years). Tumor sites included
the nasal cavity and paranasal sinuses (42%), nasopharynx and oropharynx (19%), oral
cavity (12%), major salivary glands (12%), and others (15%). Tumor classifications
were T4 in 200 (69%) patients, T3 in 45 (16%), T2 in 22 (8%), T1 in 15 (5%), and
unclassified in 7 (2%). The median total dose was 64 Gy (relative biological effectiveness
[RBE]; range, 55.2-70.4 Gy [RBE]) in 16 fractions (range, 12-32 fractions).
Median follow-up time was 30 months (range, 2-118 months). The 2-year overall survival,
progression-free survival, and local control rates were 94%, 68%, and 88%,
respectively. Estimated 5-year overall survival, progression-free survival, and local
control rates were 74%, 44%, and 68%, respectively. In all, 43 patients (15%) experienced
grade 3 late toxicity, of which osteonecrosis of the jaw bone was the most
common. Two patients treated for nasopharyngeal ACC died from a bleeding ulcer
at the tumor site (grade 5 toxicity).
Conclusions: Carbon-ion radiation therapy seems to be a promising treatment for
ACC of the head and neck. 2017 Elsevier Inc. All rights reserved.
雑誌名
International Journal of Radiation Oncology Biology Physics
Multicenter Study of Carbon-Ion Radiation Therapy for Adenoid Cystic Carcinoma of the Head and Neck: Subanalysis of the Japan Carbon-Ion Radiation Oncology Study Group (J-CROS) Study (1402 HN)
