Monali Swain1, Sarbani Ghosh-Laskar2, Ashwini Budrukkar2, Roshan Patil2, Vedang Murthy3, Tejpal Gupta3, Naveen Mummudi2, Kumar Prabhash4, Amit Joshi4, Vijay Maruti Patil4, Vanita Naronha4, Jai Prakash Agarwal2. 1. Department of Radiation Oncology, Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Dr. E. Borges Road, Parel, Mumbai, Maharashtra, 400012, India. drmonaliswain@gmail.com. 2. Department of Radiation Oncology, Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Dr. E. Borges Road, Parel, Mumbai, Maharashtra, 400012, India. 3. Department of Radiation Oncology, Advanced Centre for Treatment Research and Education for Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India. 4. Department of Medical Oncology, Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.
Abstract
PURPOSE: To analyze the outcome of locally advanced unresectable adenoid cystic carcinoma (ACC) of head and neck treated with radical concurrent chemoradiotherapy (CRT) at a single tertiary care centre. METHODS: Between 2011 and 2018, 23 patients with locally advanced unresectable ACC of head and neck treated with non-surgical radical treatment with concurrent chemoradiotherapy were evaluated for outcome and toxicity. All but one patient received cisplatin-based concurrent chemotherapy and 74% of patients were treated with intensity-modulated radiotherapy. RESULTS: Median follow-up was 53 months (range 3-115 months). Following treatment, 11 patients achieved complete response (47.8%) and of the 12 patients with residual disease, 7 patients additionally had disease stabilization without local progression. Overall 15 patients had disease progression. Median time to progression was 28 months (range 6-67 months). The 3-year and 5-year overall survival, local progression-free survival (LPFS) and distant progression-free survival (DPFS) were 78%, 79.7%, 67.4% and 63%, 50.9%, 48.6%, respectively. Acute grade 3 mucositis was observed in three patients, and one patient additionally developed grade 4 neutropenia with subsequent complete recovery. No grade 3 or higher late toxicity was observed. CONCLUSION: Radical concurrent chemoradiotherapy is a promising treatment option in locally advanced unresectable ACC with acceptable toxicity.
PURPOSE: To analyze the outcome of locally advanced unresectable adenoid cystic carcinoma (ACC) of head and neck treated with radical concurrent chemoradiotherapy (CRT) at a single tertiary care centre. METHODS: Between 2011 and 2018, 23 patients with locally advanced unresectable ACC of head and neck treated with non-surgical radical treatment with concurrent chemoradiotherapy were evaluated for outcome and toxicity. All but one patient received cisplatin-based concurrent chemotherapy and 74% of patients were treated with intensity-modulated radiotherapy. RESULTS: Median follow-up was 53 months (range 3-115 months). Following treatment, 11 patients achieved complete response (47.8%) and of the 12 patients with residual disease, 7 patients additionally had disease stabilization without local progression. Overall 15 patients had disease progression. Median time to progression was 28 months (range 6-67 months). The 3-year and 5-year overall survival, local progression-free survival (LPFS) and distant progression-free survival (DPFS) were 78%, 79.7%, 67.4% and 63%, 50.9%, 48.6%, respectively. Acute grade 3 mucositis was observed in three patients, and one patient additionally developed grade 4 neutropenia with subsequent complete recovery. No grade 3 or higher late toxicity was observed. CONCLUSION: Radical concurrent chemoradiotherapy is a promising treatment option in locally advanced unresectable ACC with acceptable toxicity.
Entities:
Keywords:
Adenoid cystic carcinoma; Chemoradiotherapy; Head and neck; Outcomes
Authors: William M Mendenhall; Christopher G Morris; Robert J Amdur; John W Werning; Russell W Hinerman; Douglas B Villaret Journal: Head Neck Date: 2004-02 Impact factor: 3.147
Authors: Andrés Coca-Pelaz; Juan P Rodrigo; Patrick J Bradley; Vincent Vander Poorten; Asterios Triantafyllou; Jennifer L Hunt; Primož Strojan; Alessandra Rinaldo; Missak Haigentz; Robert P Takes; Vanni Mondin; Afshin Teymoortash; Lester D R Thompson; Alfio Ferlito Journal: Oral Oncol Date: 2015-05-02 Impact factor: 5.337
Authors: Christopher L Ellington; Michael Goodman; Scott A Kono; William Grist; Trad Wadsworth; Amy Y Chen; Taofeek Owonikoko; Suresh Ramalingam; Dong M Shin; Fadlo R Khuri; Jonathan J Beitler; Nabil F Saba Journal: Cancer Date: 2012-01-31 Impact factor: 6.860
Authors: Allen M Chen; M Kara Bucci; Jeanne M Quivey; Joaquin Garcia; David W Eisele; Karen K Fu Journal: Int J Radiat Oncol Biol Phys Date: 2006-09-11 Impact factor: 7.038
Authors: Youssef H Zeidan; Leonid Pekelis; Yi An; Floyd Christopher Holsinger; Christina S Kong; Daniel T Chang; Quynh-Thu Le Journal: Oral Oncol Date: 2015-03-11 Impact factor: 5.337
Authors: Alen N Cohen; Edward J Damrose; Robert Y Huang; Scott D Nelson; Keith E Blackwell; Thomas C Calcaterra Journal: Otolaryngol Head Neck Surg Date: 2004-12 Impact factor: 3.497
Authors: J P Agarwal; Sandeep Jain; Tejpal Gupta; Meena Tiwari; S G Laskar; K A Dinshaw; Pankaj Chaturvedi; Anil K D'cruz; S K Shrivastava Journal: Oral Oncol Date: 2008-03-07 Impact factor: 5.337