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

Published online by Cambridge University Press:  02 July 2009

T A Iseli ,
L H Karnell ,
S M Graham ,
G F Funk ,
J M Buatti ,
A K Gupta ,
R A Robinson  and
H T Hoffman
T A Iseli*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
L H Karnell
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
S M Graham
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
G F Funk
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
J M Buatti
Affiliation:
Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
A K Gupta
Affiliation:
Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
R A Robinson
Affiliation:
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
H T Hoffman
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
*
Address for correspondence: Dr Tim Iseli, Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA. Fax: +1 319 356 4547 E-mail: [email protected]
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Abstract

This study retrospectively reviewed 183 cases of adenoid cystic carcinoma treated over 40 years. The local recurrence free survival rate was 68.2 per cent at five years and 40.8 per cent at 10 years. At 10 years, local recurrence free survival was significantly worse following radiotherapy alone (0 per cent), compared with surgery alone (41.8 per cent, p = 0.004) or combined with post-operative radiotherapy (43.5 per cent, p = 0.001). Neither tumour stage three or four, perineural invasion, solid subtype nor involved margins predicted local recurrence. Treatment with radiotherapy alone resulted in worse survival than surgery alone (p = 0.002) or combined with post-operative radiotherapy (p = 0.001). Survival rates following local recurrence (n = 34) were higher following surgery (p = 0.006) but not significantly improved following radiotherapy (p = 0.139). Chemotherapy for distant metastases did not prolong survival (p = 0.747) but did result in improved eating and aesthetics scores, while decreasing overall physical health. These results indicate that surgery is preferable for primary and recurrent adenoid cystic carcinoma of the head and neck. The incidence of local recurrence following surgery and postoperative radiotherapy was similar to surgery alone cases although the latter had less adverse prognostic features. Contemporary chemotherapy may benefit quality of life but not survival in patients with distant metastases due to adenoid cystic carcinoma of the head and neck.

Keywords

Adenoid Cystic CarcinomaHead And Neck NeoplasmsSurgeryRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 10 , October 2009 , pp. 1137 - 1144
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the American Head & Neck Society 7th International San Francisco, 20 July 2008, San Francisco, California, USA.

References

1Bradley, PJ. Adenoid cystic carcinoma of the head and neck: a review. Curr Opin Otolaryngol Head Neck Surg 2004;12:127–32Google Scholar
2Funk, GF, Karnell, LH, Christensen, AJ, Moran, PJ, Ricks, J. Comprehensive head and neck oncology health status assessment. Head Neck 2003;25:561–75CrossRefGoogle ScholarPubMed
3Funk, GF, Karnell, LH, Smith, RB, Christensen, AJ. Clinical significance of health status assessment measures in head and neck cancer. Arch Otolaryngol Head Neck Surg 2004;130:825–9CrossRefGoogle ScholarPubMed
4Conley, JJ, Casler, JD. Adenoid Cystic Cancer of the Head and Neck. New York: Thieme, 1991Google Scholar
5Gurney, TA, Eisele, DW, Weinberg, V, Shin, E, Lee, N. Adenoid cystic carcinoma of the major salivary glands treated with surgery and radiation. Laryngoscope 2005;115:1278–82CrossRefGoogle ScholarPubMed
6Prokopakis, EP, Snyderman, CH, Hanna, EY, Carrau, RL, Johnson, JT, D'Amico, F. Risk factors for local recurrence of adenoid cystic carcinoma: the role of post-operative radiotherapy. Am J Otolaryngol 1999;20:281–6Google Scholar
7Mendenhall, WM, Morris, CG, Amdur, RJ, Werning, JW, Hinderman, RW, Villaret, DB. Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck. Head Neck 2004;26:154–62CrossRefGoogle ScholarPubMed
8Hosokawa, Y, Ohmori, K, Kaneko, M, Yamasaki, M, Ahmed, M, Arimoto, T et al. Analysis of adenoid cystic carcinoma treated by radiotherapy. Oral Surg Med Oral Pathol Oral Radiol Endod 1992;74:251–5Google Scholar
9Van der Wal, JE, Becking, AG, Snow, GB, van der Waal, I. Distant metastases of adenoid cystic carcinoma of the salivary glands and the value of diagnostic examinations during follow-up. Head Neck 2002;24:779–83CrossRefGoogle ScholarPubMed
10Sung, M-W, Kim, KH, Kim, J-W, Min, Y-G, Seong, W-J, Roh, J-L et al. Clinicopathologic predictors and impact of distant metastasis from adenoid cystic carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 2003;129:1193–7CrossRefGoogle ScholarPubMed
11Gormley, WB, Sekhar, LN, Wright, DC, Olding, M, Janecka, IP, Synderman, CH et al. Management and long-term outcome of adenoid cystic carcinoma with intracranial extension: a neurosurgical perspective. Neurosurgery 1996;38:1105–13CrossRefGoogle ScholarPubMed
12Pommier, P, Liebsch, NJ, Deshcler, DG, Lin, DT, McIntyre, JF, Barber, FG et al. Proton beam radiation therapy for skull base adenoid cystic carcinoma. Arch Otolaryngol Head Neck Surg 2006;132:1242–1249CrossRefGoogle ScholarPubMed
13Kaplan, MJ, Johns, ME, Cantrell, RW. Chemotherapy for salivary gland cancer. Otolaryngol Head Neck Surg 1986;95:165–70CrossRefGoogle ScholarPubMed