Adenoid cystic carcinoma of the head and neck treated by surgery with or without postoperative radiation therapy: Prognostic features of recurrence

Journal Article · Fri Sep 01 04:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.04.014· OSTI ID:20850064

Chen, Allen M ^[1]; Bucci, M Kara ^[1]; Weinberg, Vivian ^[2]; Garcia, Joaquin ^[3]; Quivey, Jeanne M ^[1]; Schechter, Naomi R ^[1]; Phillips, Theodore L ^[1]; Fu, Karen K ^[1]; Eisele, David W ^[4]

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1. Department of Radiation Oncology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)
2. Department of Biostatistics, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)
3. Department of Pathology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)
4. Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)

Purpose: This study sought to review a single-institution experience with the management of adenoid cystic carcinoma of the head and neck. Methods and Materials: Between 1960 and 2004, 140 patients with adenoid cystic carcinoma of the head and neck were treated with definitive surgery. Ninety patients (64%) received postoperative radiation to a median dose of 64 Gy (range, 54-71 Gy). Distribution of T stage was: 26% T1, 28% T2, 20% T3, and 26% T4. Seventy-eight patients (56%) had microscopically positive margins. Median follow-up was 66 months (range, 7-267 months). Results: The 5- and 10-year rate estimates of local control were 88% and 77%, respectively. A Cox proportional hazards model identified T4 disease (p = 0.0001), perineural invasion (p = 0.008), omission of postoperative radiation (p = 0.007), and major nerve involvement (p = 0.02) as independent predictors of local recurrence. Radiation dose lower than 60 Gy (p = 0.0004), T4 disease (p 0.005), and major nerve involvement (p = 0.02) were predictors of local recurrence among those treated with surgery and postoperative radiation. The 10-year overall survival and distant metastasis-free survival were 64% and 66%, respectively. Conclusion: Combined-modality therapy with surgery followed by radiation to doses in excess of 60 Gy should be considered the standard of care for adenoid cystic carcinoma of the head and neck.

• OSTI ID: 20850064
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 66; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
HEAD
METASTASES
NECK
PATIENTS
RADIATION DOSES
RADIOTHERAPY
REVIEWS
SALIVARY GLANDS
SURGERY