Journal Article A Multicenter Study of Carbon-Ion Radiation Therapy for Head and Neck Adenocarcinoma

Jun-ichi, Saitoh  ,  Koto, Masashi  ,  Demizu, Yusuke  ,  Suefuji, Hiroaki  ,  Ohno, Tatsuya  ,  Tsuji, Hiroshi  ,  Okimoto, Tomoaki  ,  Shioyama, Yoshiyuki  ,  Nemoto, Kenji  ,  Nakano, Takashi  ,  Kamada, Tadashi

99 ( 2 )  , pp.442 - 449 , 2017-10 , Elsevier Inc
Description
Purpose: Head and neck (HN) adenocarcinoma is rare, and to date, there have been noreports of prospective studies. We retrospectively evaluated the efficacy and safety ofcarbon-ion radiation therapy (C-ion RT) for HN adenocarcinoma in institutions inJapan.Methods and Materials: HN adenocarcinoma patients with N0M0 or N1M0 diseasewho were treated with C-ion RT at institutions in Japan between November 2003and December 2014 were analyzed retrospectively. We enrolled 47 patients (30 maleand 17 female patients; median age, 60 years) with HN adenocarcinoma.Results: Primary sites included the nasal and paranasal sinus in 21 patients, orbit in11, salivary grand in 7, oral cavity and pharynx in 6, and acoustic organ in 2.Thirty-two patients had T4 tumors, 6 had T3, and 6 had T2. Forty-five patientsreceived a diagnosis of N0 disease, whereas 2 had N1 disease. The median total doseof C-ion RT and the number of fractions were 64.0 Gy (relative biological effectiveness)and 16 fractions, respectively. The median follow-up period was 51 months(range, 6-118 months). The 2- and 5-year overall survival rates were 87.9% and60.4%, respectively, and the 2- and 5-year local control rates were 83.3% and79.3%, respectively. Multivariate analysis showed that operability (patients withoperable tumors) (PZ.045) and fractionation (16 fractions) (PZ.010) were significant independent prognostic factors for better overall survival. No grade 5 late morbiditieswere observed. Grade 4 late morbidities were observed in 4 patients, and all ofthese grade 4 morbidities were visual impairments. All 4 patients with grade 4 visualimpairment had T4 tumors in the nasopharynx or paranasal sinuses, which impliedinoperable tumors with orbital or brain invasion.

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