Treatment of Cutaneous Adnexal Carcinoma With Radiotherapy: A 20-Year, Single-Institution Experience in 49 Patients.

IF 1.8 4区 医学 Q4 ONCOLOGY
Nader Mohamed, Sarah Mattessich, Daphna Y Gelblum, Nancy Y Lee, Christopher A Barker
{"title":"Treatment of Cutaneous Adnexal Carcinoma With Radiotherapy: A 20-Year, Single-Institution Experience in 49 Patients.","authors":"Nader Mohamed, Sarah Mattessich, Daphna Y Gelblum, Nancy Y Lee, Christopher A Barker","doi":"10.1097/COC.0000000000001163","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Cutaneous adnexal carcinomas (CACs) are rare skin cancers with no established treatment guidelines. Given the limited data, this study aims to explore the characteristics and outcomes of patients with CAC treated with radiation therapy (RT).</p><p><strong>Methods: </strong>Patients diagnosed with CAC between 2000 and 2020 who received RT were included. Kaplan-Meier methods measured time to local recurrence (LR), regional recurrence (RR), locoregional recurrence (LRR), distant metastasis (DM), and progression-free survival (PFS). Fisher exact test compared frequency distributions.</p><p><strong>Results: </strong>Forty-nine patients with an average age of 65 years were studied. Most were White males with head and neck tumors. Common subtypes were adnexal adenocarcinoma, sebaceous carcinoma, and microcystic adnexal carcinoma. Patients received RT diagnosis or recurrence. The median overall survival was 44 months, with a median follow-up of 41 months for surviving patients. For patients with de novo cancer treated with surgery and adjuvant RT (n=22), 2-year PFS, LR, RR, LRR, DM, and OS were 77%, 5%, 0%, 5%, 10%, and 95%, respectively, with all LRR occurring outside the irradiated area. Patients with de novo cancer who received definitive RT (n=9) experienced 2-year PFS, LR, RR, LRR, DM, and OS of 30%, 46%, 13%, 55%, 40%, and 67%, respectively, with all LRR events occurring within the irradiated area. LR within the irradiated volume was associated with immunosuppression (95% CI: 19-99). Patients treated at recurrence had inferior outcomes.</p><p><strong>Conclusions: </strong>Surgical resection and adjuvant RT effectively control CAC, while definitive RT shows lower disease control. Novel strategies are needed to improve outcomes in patients receiving definitive RT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"193-199"},"PeriodicalIF":1.8000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Oncology-Cancer Clinical Trials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/COC.0000000000001163","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/29 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: Cutaneous adnexal carcinomas (CACs) are rare skin cancers with no established treatment guidelines. Given the limited data, this study aims to explore the characteristics and outcomes of patients with CAC treated with radiation therapy (RT).

Methods: Patients diagnosed with CAC between 2000 and 2020 who received RT were included. Kaplan-Meier methods measured time to local recurrence (LR), regional recurrence (RR), locoregional recurrence (LRR), distant metastasis (DM), and progression-free survival (PFS). Fisher exact test compared frequency distributions.

Results: Forty-nine patients with an average age of 65 years were studied. Most were White males with head and neck tumors. Common subtypes were adnexal adenocarcinoma, sebaceous carcinoma, and microcystic adnexal carcinoma. Patients received RT diagnosis or recurrence. The median overall survival was 44 months, with a median follow-up of 41 months for surviving patients. For patients with de novo cancer treated with surgery and adjuvant RT (n=22), 2-year PFS, LR, RR, LRR, DM, and OS were 77%, 5%, 0%, 5%, 10%, and 95%, respectively, with all LRR occurring outside the irradiated area. Patients with de novo cancer who received definitive RT (n=9) experienced 2-year PFS, LR, RR, LRR, DM, and OS of 30%, 46%, 13%, 55%, 40%, and 67%, respectively, with all LRR events occurring within the irradiated area. LR within the irradiated volume was associated with immunosuppression (95% CI: 19-99). Patients treated at recurrence had inferior outcomes.

Conclusions: Surgical resection and adjuvant RT effectively control CAC, while definitive RT shows lower disease control. Novel strategies are needed to improve outcomes in patients receiving definitive RT.

放疗治疗皮肤附件癌:20年,单机构49例患者的经验。
目的:皮肤附件癌(cac)是一种罕见的皮肤癌,没有既定的治疗指南。鉴于数据有限,本研究旨在探讨放疗(RT)治疗CAC患者的特点和预后。方法:纳入2000年至2020年间诊断为CAC并接受RT治疗的患者。Kaplan-Meier方法测量了局部复发时间(LR)、区域复发时间(RR)、局部区域复发时间(LRR)、远处转移时间(DM)和无进展生存时间(PFS)。Fisher精确检验比较了频率分布。结果:49例患者平均年龄65岁。大多数是头颈部肿瘤的白人男性。常见亚型为附件腺癌、皮脂腺癌和微囊性附件癌。患者接受RT诊断或复发。中位总生存期为44个月,存活患者的中位随访期为41个月。对于接受手术和辅助放疗的新发癌症患者(n=22), 2年PFS、LR、RR、LRR、DM和OS分别为77%、5%、0%、5%、10%和95%,所有LRR均发生在放疗区以外。接受最终放疗的新发癌症患者(n=9)的2年PFS、LR、RR、LRR、DM和OS分别为30%、46%、13%、55%、40%和67%,所有LRR事件均发生在放疗区域内。放射体积内LR与免疫抑制相关(95% CI: 19-99)。复发患者的治疗效果较差。结论:手术切除和辅助RT能有效控制CAC,而明确RT则显示较低的疾病控制率。需要新的策略来改善接受最终放疗的患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.90
自引率
0.00%
发文量
130
审稿时长
4-8 weeks
期刊介绍: ​​​​​​​American Journal of Clinical Oncology is a multidisciplinary journal for cancer surgeons, radiation oncologists, medical oncologists, GYN oncologists, and pediatric oncologists. The emphasis of AJCO is on combined modality multidisciplinary loco-regional management of cancer. The journal also gives emphasis to translational research, outcome studies, and cost utility analyses, and includes opinion pieces and review articles. The editorial board includes a large number of distinguished surgeons, radiation oncologists, medical oncologists, GYN oncologists, pediatric oncologists, and others who are internationally recognized for expertise in their fields.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信