Long-term outcomes after particle radiation therapy in patients with nasopharyngeal adenoid cystic carcinoma.

BMC Cancer

Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China.

Published: June 2024

AI Article Synopsis

  • Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare salivary gland tumor with poor outcomes, and high-dose particle beam radiation therapy (PBRT) is a key treatment for it.
  • In a study of 26 patients with nonmetastatic NACC, most received a combination of intensity-modulated proton therapy and carbon ion therapy, leading to impressive survival rates at 3- and 4-years post-treatment.
  • Results showed a 91.7% overall survival rate and minimal severe toxicity, suggesting that PBRT is an effective and relatively safe treatment option for locally advanced NACC, but further research is needed.

Article Abstract

Background: Nasopharyngeal adenoid cystic carcinoma (NACC) is a relatively rare salivary gland tumor that is generally associated with poor outcomes. High-dose radiotherapy is a key treatment for patients with NACC. This study reported the long-term efficacy and safety of particle beam radiation therapy (PBRT) for NACC.

Methods And Materials: Twenty-six patients with nonmetastatic NACC who received definitive PBRT alone were included in this retrospective study. The majority of patients (92.3%) had locally advanced disease. Twenty-five (96.15%) patients received intensity-modulated proton radiotherapy (IMPT) followed by a carbon ion radiotherapy (CIRT) boost, and one patient received CIRT alone. Overall survival (OS), local control (LC), regional control (RC), and distant metastasis control (DMC) rates were calculated via the Kaplan-Meier method.

Results: The median follow-up time was 46.95 months for the entire cohort. Seven patients experienced local recurrence, and one patient experience neck lymph node recurrence. The 3- and 4-year OS, LC, RC, and DMC rates were 100% and 91.7%, 92.3% and 84.6%, 95.8% and 87.8%, and 90.2% and 71.3%, respectively. A total of 91.3% of the patients achieved complete remission of gross tumors at 1 year after PBRT. Severe acute toxicity was observed in only two patients. A grade 4 decrease in visual acuity was observed in one patient with orbital apex invasion. No late grade 3 or 5 toxicity was observed.

Conclusion: Definitive PBRT provided a satisfactory 4-year OS for patients with locally advanced NACC. The toxicity was acceptable and mild. Further follow-up is necessary to confirm the efficacy and safety of definitive PBRT for patients with NACC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186262PMC
http://dx.doi.org/10.1186/s12885-024-12471-8DOI Listing

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