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Post-operative accelerated hypofractionated radiotherapy for adenoid cystic carcinoma

Published online by Cambridge University Press:  12 November 2010

Jennifer Sherriff ,
Urmila Barthakur ,
Paul Sanghera ,
Christopher McConkey ,
Christopher Rusius ,
Andrew Hartley  and
John Glaholm
Jennifer Sherriff
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK
Urmila Barthakur
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK
Paul Sanghera*
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK Division of Cancer Studies, University of Birmingham, Birmingham, UK
Christopher McConkey
Affiliation:
Clinical Trial Unit, University of Warwick, Coventry, UK
Christopher Rusius
Affiliation:
Medical School, University of Birmingham, Birmingham, UK
Andrew Hartley
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK Division of Cancer Studies, University of Birmingham, Birmingham, UK
John Glaholm
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK Division of Cancer Studies, University of Birmingham, Birmingham, UK
*
Correspondence to: Paul Sanghera, Cancer Centre, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK. E-mail: [email protected]
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Abstract

Objective: To examine the outcomes of patients with adenoid cystic carcinoma (ACC) treated with post-operative accelerated hypofractionated radiotherapy (AHRT).

Methods: Patients treated with AHRT (50–55 Gy in 20 fractions over 25 days) between 1997 and 2008 were identified and retrospectively analysed. Data collection included site of primary and surgical excision margin. Primary outcomes were overall survival (OS) and local control (LC) calculated using the Kaplan–Meier method.

Results: A total of 37 patients meeting the above criteria were identified with a median age of 55 years (range 31–79). Distribution by anatomical site was as follows: parotid 9 patients; submandibular gland 8 patients; other salivary gland tissue 20 patients. Surgical excision margins were as follows: non-involved 25 patients; microscopic involvement 7 patients; macroscopic involvement 4 patients; unknown 1 patient. Median follow-up was 59 (range 14–126) months. Five patients had local recurrence, 4 distant recurrences, and 1 both local and distant recurrence. The 5-year LC and OS rates were 81.8% (95% confidence intervals (CIs) 60.9–92.2) and 78.5% (95% CI 58.0–89.8%), respectively.

Conclusion: Outcomes with post-operative AHRT appear comparable to those in the literature. However, until more is known about the radiobiology of this rare disease, a biological equivalent of 60 Gy in 2 gray fractions without correction for accelerated repopulation should be used.

Keywords

Accelerated hypofractionated radiotherapyadenoid cystic carcinoma
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 10 , Issue 2 , June 2011 , pp. 85 - 90
Copyright
Copyright © Cambridge University Press 2010

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References

Chen, AM, Bucci, MK, Weinberg, V, Garcia, J, Quivey, JM, Schechter, NR, Phillips, TL, Fu, KK, Eisele, DW. Adenoid cystic carcinoma of the head and neck treated by surgery with or without postoperative radiation therapy: prognostic features of recurrence. Int J Radiat Oncol Biol Phys 2006; 66: 152–159.CrossRefGoogle ScholarPubMed
Garden, AS, Weber, RS, Morrison, WH, Ang, KK, Peters, LJ. The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation. Int J Radiat Oncol Biol Phys 1995; 32: 619–626.CrossRefGoogle ScholarPubMed
Simpson, JR, Thawley, SE, Matsuba, HM. Adenoid cystic salivary gland carcinoma: treatment with irradiation and surgery. Radiology 1984; 151: 509–512.Google Scholar
Gomez, DR, Hoppe, BS, Wolden, SL, Zhung, JE, Patel, SG, Kraus, DH, Shah, JP, Ghossein, RA, Lee, NY. Outcomes and prognostic variables in adenoid cystic carcinoma of the head and neck: a recent experience. Int J Radiat Oncol Biol Phys 2008; 70: 1365–1372.Google Scholar
Gurney, 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: 1278–1282.CrossRefGoogle ScholarPubMed
Mendenhall, WM, Morris, CG, Amdur, RJ, Werning, JW, Hinerman, RW, Villaret, DB. Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck. Head Neck 2004; 26: 154–162.CrossRefGoogle ScholarPubMed
Chunying, S, Hu, C, He, S. The treatment results and prognostic analyses of 54 cases with adenoid cystic carcinoma originated from the major salivary glands. Proceedings of the 51st Annual ASTRO Meeting 2009. Abstract 2516.Google Scholar
Khan, AJ, DiGiovanna, MP, Ross, DA, Sasaki, CT, Carter, D, Son, YH, Haffty, BG. Adenoid cystic carcinoma: a retrospective clinical review. Int J Cancer 2001; 96: 149–158.Google Scholar
Terhaard, CH, Lubsen, HVan der Tweel, I, Hilgers, FJ, Eijkenboom, WM, Marres, HATjho-Heslinga, REde Jong, JMRoodenburg, JL; Dutch Head and Neck Oncology Cooperative Group. Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck 2004; 26: 681–92; discussion 692.Google Scholar
Sanghera, P, McConkey, C, Ho, KF, Glaholm, J, Hartley, A. Hypofractionated accelerated radiotherapy with concurrent chemotherapy for locally advanced squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 2007; 67: 1342–1351.Google Scholar
Yeoh, EE, Holloway, RH, Fraser, RJ, Botten, RJDi Matteo, AC, Butters, J, Weerasinghe, S, Abeysinghe, P. Hypofractionated versus conventionally fractionated radiation therapy for prostate carcinoma: updated results of a phase III randomized trial. Int J Radiat Oncol Biol Phys 2006; 66: 1072–1083.Google Scholar
Brenner, DJ, Martinez, AA, Edmundson, GK, Mitchell, C, Thames, HD, Armour, EP. Direct evidence that prostate tumors show high sensitivity to fractionation (low alpha/beta ratio), similar to late-responding normal tissue. Int J Radiat Oncol Biol Phys 2002; 52: 6–13.Google Scholar
Silverman, DA, Carlson, TP, Khuntia, D, Bergstrom, RT, Saxton, J, Esclamado, RM. Role for postoperative radiation therapy in adenoid cystic carcinoma of the head and neck. Laryngoscope 2004; 114: 1194–1199.CrossRefGoogle ScholarPubMed
Iseli, TA, Karnell, LH, Graham, SM, Funk, GF, Buatti, JM, Gupta, AK, Robinson, RA, Hoffman, HT. Role of radiotherapy in adenoid cystic carcinoma of the head and neck. J Laryngol Otol 2009; 123: 1137–1144.Google Scholar