Adenoid cystic carcinoma of the head and neck: Patterns of recurrence and implications for intensity-modulated radiotherapy

Robert W. Gao, David M. Routman, William S. Harmsen, Sasha Ebrahimi, Robert Foote, Daniel J Ma, Michelle Neben-Wittich, Lisa A. McGee, Samir H Patel, Eric J. Moore, Garret W. Choby, Kendall K. Tasche, Katharine A. Price, Mauricio E. Gamez, Scott C. Lester

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We seek to inform radiotherapy (RT) delivery for adenoid cystic carcinoma of the head and neck (ACC) by evaluating RT techniques and recurrence patterns. Methods: We identified patients with ACC treated with curative-intent RT from 2005 to 2021. Imaging was reviewed to determine local recurrence (LR). Results: Ninety-one patients were included. The 5-year LR risk was 12.2% (6.6–22.7). One patient each experienced a marginal and out-of-field recurrence. Patients receiving >60 Gy postoperatively had a 5-year LR risk of 0% compared to 10.7% (4.2–27.2) with ≤60 Gy. Those receiving 70 and <70 Gy definitively had a 5-year LR risk of 15.2% (2.5–91.6) and 33.3% (6.7–100.0), respectively. No patients had regional nodal failure. Conclusions: Modern, conformal RT for ACC results in low rates of LR. Doses >60 and 70 Gy may improve control in the postoperative and definitive settings, respectively. Elective nodal treatment can be omitted in well-selected patients.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - 2022

Keywords

  • adenoid cystic carcinoma
  • adjuvant radiotherapy
  • conformal radiotherapy
  • head and neck neoplasms
  • intensity-modulated radiotherapy

ASJC Scopus subject areas

  • Otorhinolaryngology

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