Journal Article 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)

Shazrina Sulaiman,, Nor  ,  Demizu, Yuusuke  ,  Koto, Masashi  ,  Saitou, Jyunnichi  ,  Suefuji, Hiroaki  ,  Tsuji, Hiroshi  ,  Ohno, Tatsuya  ,  Shioyama, Yoshiyuki  ,  Okimoto, Tomoaki  ,  Daimon, Takashi  ,  Nemoto, Kenji  ,  Nakano, Takashi  ,  Kamada, Tadashi

SummaryAdenoid cystic carcinomas of the head and neck are rare, comparatively radioresistant tumors. In this large cohort of a retrospective multicenterstudy, we evaluated the effectiveness and safety of carbon-ion radiation therapyin 289 patients with adenoid cystic carcinoma of the head and neck. The physical and biological characteristics of carbon-ions allowed deliveryof localized high tumor doses, resulting in good local control and overall survivalwith tolerable treatmentrelated toxicity.Purpose: To retrospectively analyze the treatment outcomes of carbon-ion radiationtherapy for adenoid cystic carcinoma (ACC) of the head and neck at 4 activecarbon-ion facilities in Japan.Methods and Materials: A total of 289 patients who underwent carbon-ion radiationtherapy for histology-proven ACC of the head and neck at 4 institutions in Japan betweenNovember 2003 and December 2014 were included in this study.Results: Median patient age was 58 years (range, 12-83 years). Tumor sites includedthe nasal cavity and paranasal sinuses (42%), nasopharynx and oropharynx (19%), oralcavity (12%), major salivary glands (12%), and others (15%). Tumor classificationswere T4 in 200 (69%) patients, T3 in 45 (16%), T2 in 22 (8%), T1 in 15 (5%), andunclassified 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 localcontrol rates were 74%, 44%, and 68%, respectively. In all, 43 patients (15%) experiencedgrade 3 late toxicity, of which osteonecrosis of the jaw bone was the mostcommon. Two patients treated for nasopharyngeal ACC died from a bleeding ulcerat the tumor site (grade 5 toxicity).Conclusions: Carbon-ion radiation therapy seems to be a promising treatment forACC of the head and neck. 2017 Elsevier Inc. All rights reserved.

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