Onita Bhattasali1, Emma Holliday2, Merrill S Kies3, Ehab Y Hanna4, Adam S Garden2, David I Rosenthal2, William H Morrison2, G Brandon Gunn2, C David Fuller2, X Ronald Zhu5, Steven J Frank2. 1. Department of Radiation Oncology, Kaiser Permanente Medical Center, Los Angeles, California. 2. Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 4. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: The primary treatment for head and neck adenoid cystic carcinoma (ACC) is surgery. Infrequently, however, ACC's propensity for perineural and base of skull invasion can preclude definitive surgical management. We present our experience with proton radiation therapy (RT) and concurrent platinum-based chemotherapy. METHODS: Nine patients with unresectable node-negative, nonmetastatic head and neck ACC received definitive proton RT and concurrent cisplatin. Outcomes and toxicities were recorded. A systematic review of the literature was performed. RESULTS: Median follow-up was 27 months (range, 9.2-48.3 months). Four patients achieved complete response at the primary site, and an additional 4 patients achieved stabilization of local disease. Only 1 patient developed local disease progression. Four patients had 5 acute grade 3 (G3) toxicities, and 1 patient developed a chronic G4 optic nerve disorder. CONCLUSION: Our preliminary results suggest proton RT and concurrent chemotherapy is a definitive treatment option for select patients with head and neck ACC.
BACKGROUND: The primary treatment for head and neck adenoid cystic carcinoma (ACC) is surgery. Infrequently, however, ACC's propensity for perineural and base of skull invasion can preclude definitive surgical management. We present our experience with proton radiation therapy (RT) and concurrent platinum-based chemotherapy. METHODS: Nine patients with unresectable node-negative, nonmetastatic head and neck ACC received definitive proton RT and concurrent cisplatin. Outcomes and toxicities were recorded. A systematic review of the literature was performed. RESULTS: Median follow-up was 27 months (range, 9.2-48.3 months). Four patients achieved complete response at the primary site, and an additional 4 patients achieved stabilization of local disease. Only 1 patient developed local disease progression. Four patients had 5 acute grade 3 (G3) toxicities, and 1 patient developed a chronic G4 optic nerve disorder. CONCLUSION: Our preliminary results suggest proton RT and concurrent chemotherapy is a definitive treatment option for select patients with head and neck ACC.
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