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 L. 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

doi:10.1002/hed.27223

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 L. 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 journal › Article › peer-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 language	English (US)
Pages (from-to)	187-196
Number of pages	10
Journal	Head and Neck
Volume	45
Issue number	1
DOIs	https://doi.org/10.1002/hed.27223
State	Published - Jan 2023

Keywords

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

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.27223

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Gao, R. W., Routman, D. M., Harmsen, W. S., Ebrahimi, S., Foote, R. L., Ma, D. J., Neben-Wittich, M., McGee, L. A., Patel, S. H., Moore, E. J., Choby, G. W., Tasche, K. K., Price, K. A., Gamez, M. E., & Lester, S. C. (2023). Adenoid cystic carcinoma of the head and neck: Patterns of recurrence and implications for intensity-modulated radiotherapy. Head and Neck, 45(1), 187-196. https://doi.org/10.1002/hed.27223

Gao, RW, Routman, DM, Harmsen, WS, Ebrahimi, S, Foote, RL, Ma, DJ, Neben-Wittich, M, McGee, LA, Patel, SH, Moore, EJ, Choby, GW, Tasche, KK, Price, KA, Gamez, ME & Lester, SC 2023, 'Adenoid cystic carcinoma of the head and neck: Patterns of recurrence and implications for intensity-modulated radiotherapy', Head and Neck, vol. 45, no. 1, pp. 187-196. https://doi.org/10.1002/hed.27223

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

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.",

keywords = "adenoid cystic carcinoma, adjuvant radiotherapy, conformal radiotherapy, head and neck neoplasms, intensity-modulated radiotherapy",

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

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doi = "10.1002/hed.27223",

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T2 - Patterns of recurrence and implications for intensity-modulated radiotherapy

AU - Gao, Robert W.

AU - Routman, David M.

AU - Harmsen, William S.

AU - Ebrahimi, Sasha

AU - Foote, Robert L.

AU - Ma, Daniel J.

AU - Neben-Wittich, Michelle

AU - McGee, Lisa A.

AU - Patel, Samir H.

AU - Moore, Eric J.

AU - Choby, Garret W.

AU - Tasche, Kendall K.

AU - Price, Katharine A.

AU - Gamez, Mauricio E.

AU - Lester, Scott C.

PY - 2023/1

Y1 - 2023/1

N2 - 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.

AB - 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.

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

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