Impact of perineural tumor spread in head and neck adenoid cystic carcinoma for carbon-ion radiotherapy

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2025-01-30 DOI:10.1016/j.ctro.2025.100928

Atsushi Musha , Nobuteru Kubo , Hidemasa Kawamura , Naoko Okano , Masahiro Onishi , Takeru Ohtaka , Midori Tamura , Osamu Nikkuni , Yuichi Tomidokoro , Satoshi Yokoo , Kazuaki Chikamatsu , Tatsuya Ohno

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Abstract

Background and purpose

Despite recognizing the effectiveness of carbon-ion radiotherapy (C-ion RT) in treating head and neck adenoid cystic carcinoma (HN-ACC), the impact of perineural tumor spread (PNTS) on treatment outcomes and the relationship between PNTS and post-treatment marginal recurrences remain unexplored. Therefore, we analyzed the efficacy of C-ion RT in HN-ACC, focusing on PNTS including details of post-treatment marginal recurrence and indicators for future treatment strategies.

Materials and methods

In this retrospective study, we included 74 patients diagnosed with HN-ACC who underwent C-ion RT between June 2010 and July 2022. Treatment dosages were either 57.6 or 64.0 Gy (relative biological effectiveness) delivered in 16 fractions. Patients undergoing C-ion RT were identified retrospectively from medical records. PNTS was evaluated by magnetic resonance imaging for detecting extratumoral extension to peritumoral nerves.

Results

The median duration of follow-up was 46.4 months. Local recurrence developed in 19 patients. Moreover, most marginal recurrences occurred within the irradiated margins. The 5-year rates for local control (LC), progression-free survival (PFS), and overall survival (OS) were 67.6 %, 47.7 %, and 79.0 %, respectively. LC (p = 0.005) and PFS (p = 0.013) demonstrated significant variances on analysis based on PNTS occurrence; however, OS did not exhibit a similar pattern.

Conclusion

Our findings highlight the importance for considering disease-specific characteristics and the need for developing targeted strategies that address the complex nature of HN-ACC, particularly in cases involving PNTS, to enhance treatment outcomes and potentially reduce recurrence rates.

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头颈部腺样囊性癌神经周围肿瘤扩散对碳离子放疗的影响

背景与目的尽管碳离子放射治疗（C-ion RT）治疗头颈部腺样囊性癌（HN-ACC）的有效性得到了认可，但神经周围肿瘤扩散（PNTS）对治疗结果的影响以及PNTS与治疗后边缘复发的关系仍未得到研究。因此，我们分析了c离子RT治疗HN-ACC的疗效，重点关注PNTS，包括治疗后边际复发的细节和未来治疗策略的指标。材料和方法在这项回顾性研究中，我们纳入了74例诊断为HN-ACC的患者，他们在2010年6月至2022年7月期间接受了c离子RT。治疗剂量为57.6 Gy或64.0 Gy（相对生物有效性），分16份递送。从医疗记录中回顾性地确定接受c离子放射治疗的患者。通过磁共振成像评估PNTS，以检测瘤外神经向瘤周神经的延伸。结果中位随访时间为46.4个月。19例出现局部复发。此外，大多数边缘复发发生在辐射边缘。局部控制（LC）、无进展生存（PFS）和总生存（OS）的5年生存率分别为67.6%、47.7%和79.0%。LC （p = 0.005）和PFS （p = 0.013）在基于PNTS发生的分析中表现出显著差异；然而，OS并没有表现出类似的模式。我们的研究结果强调了考虑疾病特异性特征的重要性，以及制定有针对性的策略来解决HN-ACC的复杂性的必要性，特别是在涉及PNTS的病例中，以提高治疗效果并潜在地降低复发率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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