Alexandra D Jensen1, Melanie Poulakis2, Anna V Nikoghosyan3, Thomas Welzel4, Matthias Uhl5, Philippe A Federspil6, Kolja Freier7, Jürgen Krauss8, Angelika Höss9, Thomas Haberer10, Oliver Jäkel11, Marc W Münter12, Daniela Schulz-Ertner13, Peter E Huber14, Jürgen Debus15. 1. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: alexdjensen@gmx.de. 2. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: Melaniepoulakis@aol.com. 3. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: Anna.nikoghosyan@helios-kliniken.de. 4. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: thomas.welzel@med.uni-heidelberg.de. 5. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: matthias.uhl@med.uni-heidelberg.de. 6. Dept of Otorhinolaryngology, University of Heidelberg, Germany. Electronic address: philippe.federspil@med.uni-heidelberg.de. 7. Dept of Dental and Oro-maxillofacial Surgery, University of Heidelberg, Germany. Electronic address: kolja.freier@med.uni-heidelberg.de. 8. Dept of Medical Oncology, National Center for Tumor Disease (NCT), Heidelberg, Germany. Electronic address: juergen.krauss@med.uni-heidelberg.de. 9. Medical Informatics and Regulatory Affairs, Heidelberg Ion Beam Therapy Centre, Germany. Electronic address: angelika.hoess@med.uni-heidelberg.de. 10. Heidelberg Ion Beam Therapy Centre, Germany. Electronic address: Thomas.haberer@med.uni-heidelberg.de. 11. Heidelberg Ion Beam Therapy Centre, Germany. Electronic address: Oliver.jaekel@med.uni-heidelberg.de. 12. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: m.muenter@klinikum-stuttgart.de. 13. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: daniela.ertner@fdk.info. 14. Molecular Radiation Oncology (E055), German Cancer Research Centre (DKFZ), Heidelberg, Germany. Electronic address: p.huber@dkfz-heidelberg.de. 15. Dept of Radiation Oncology, University of Heidelberg, Germany. Electronic address: juergen.debus@med.uni-heidelberg.de.
Abstract
PURPOSE: Locoregional control (LC) in malignant salivary gland tumors is dose-dependent, initial results with particle therapy were promising. We report our experience with raster-scanned, intensity-controlled carbon ion therapy (C12) and IMRT in 309 patients with pathologically confirmed adenoid cystic carcinoma (ACC) of the head and neck. PATIENTS AND METHODS: Treatment records of patients treated with C12 between 08/1998 and 05/2013 were evaluated regarding tumor stage, treatment, toxicity (CTCAE v3), LC, progression-free survival (PFS) and overall survival (OS). Response assessment was carried out according to RECIST1.1. RESULTS: Tumor stages were mostly advanced (T4a/b: 60%, macroscopic disease: 71%), most common sites of origin were the paranasal sinus (37%). At a median follow-up at 33.9 months, LC, PFS, and OS at 3 and 5 year estimates are 83.7%/58.5%, 67.8%/56.1%, and 88.9%/74.6%. LC correlates with T-stage but neither nodal stage, age, relapse state, nor margin status. RECIST did not correlate with LC or survival rates. CONCLUSION: IMRT plus C12 boost results in good control and survival rates at moderate toxicity. Margin status did not correlate with LC in T4 tumors, extensive and potentially mutilating surgical procedures may have to be re-evaluated. RECIST assessment did not correlate with either LC or survival rates; potentially more meaningful radiological parameters need to be developed.
PURPOSE: Locoregional control (LC) in malignant salivary gland tumors is dose-dependent, initial results with particle therapy were promising. We report our experience with raster-scanned, intensity-controlled carbon ion therapy (C12) and IMRT in 309 patients with pathologically confirmed adenoid cystic carcinoma (ACC) of the head and neck. PATIENTS AND METHODS: Treatment records of patients treated with C12 between 08/1998 and 05/2013 were evaluated regarding tumor stage, treatment, toxicity (CTCAE v3), LC, progression-free survival (PFS) and overall survival (OS). Response assessment was carried out according to RECIST1.1. RESULTS:Tumor stages were mostly advanced (T4a/b: 60%, macroscopic disease: 71%), most common sites of origin were the paranasal sinus (37%). At a median follow-up at 33.9 months, LC, PFS, and OS at 3 and 5 year estimates are 83.7%/58.5%, 67.8%/56.1%, and 88.9%/74.6%. LC correlates with T-stage but neither nodal stage, age, relapse state, nor margin status. RECIST did not correlate with LC or survival rates. CONCLUSION: IMRT plus C12 boost results in good control and survival rates at moderate toxicity. Margin status did not correlate with LC in T4 tumors, extensive and potentially mutilating surgical procedures may have to be re-evaluated. RECIST assessment did not correlate with either LC or survival rates; potentially more meaningful radiological parameters need to be developed.
Authors: Arnold Pompos; Robert L Foote; Albert C Koong; Quynh Thu Le; Radhe Mohan; Harald Paganetti; Hak Choy Journal: Front Oncol Date: 2022-06-14 Impact factor: 5.738
Authors: Laila König; Henrik Hauswald; Christa Flechtenmacher; Martina Heller; Jürgen Debus; Uwe Haberkorn; Clemens Kratochwil; Frederik Giesel Journal: Clin Transl Radiat Oncol Date: 2017-11-14