Postoperative Intensity-Modulated radiotherapy with trigeminal nerve pathway delineation for head and neck adenoid cystic carcinoma

IF 5.3 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-09-28 DOI:10.1016/j.radonc.2025.111174

Wen Jiang , Ying Xiao , Haisheng Hu , Jiang Li , Yining He , Nannan Han , Rongrong Li , Lin Zhang , Shengjin Dou , Guopei Zhu

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引用次数: 0

Abstract

Background

Head and neck adenoid cystic carcinoma (HN-ACC) is a rare, aggressive malignancy prone to perineural invasion, making treatment challenging. This study evaluates the outcomes of postoperative intensity-modulated radiation therapy (IMRT) for HN-ACC to guide radiation target delineation, optimizing radiation planning and improving patient outcomes.

Patients and Methods

A retrospective review of postoperative IMRT outcomes in HN-ACC patients from January 2015 to December 2022 was conducted. Prophylactic coverage of trigeminal nerve branches in the radiation field and cervical nodal irradiation was based on clinical/pathological assessments. The primary endpoint was 5-year locoregional recurrence-free survival (LRRFS), with secondary endpoints including progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS).

Results

A total of 328 patients were followed for a median of 61.1 months. The 5-year LRRFS, PFS, DMFS, and OS rates were 91.7 %, 63.0 %, 67.1 %, and 91.3 %, respectively. Thirty patients experienced locoregional recurrence, comprising 19 local recurrences, 6 regional recurrences, and 5 combined local and regional recurrences. Eleven patients had recurrence involving trigeminal nerve branches (8 in-field, 3 marginal).

Conclusions

Postoperative IMRT for HN-ACC, utilizing our institutional target delineation protocol that prioritizes delineating the target along the trigeminal nerve pathway, suggests favorable locoregional control and survival outcomes. These results suggest evidence-based insights that could inform clinical practice and support radiation oncologists in optimizing IMRT strategies for HN-ACC.

查看原文本刊更多论文

头颈部腺样囊性癌的术后调强放疗及三叉神经通路的划定。

背景：头颈部腺样囊性癌（HN-ACC）是一种罕见的侵袭性恶性肿瘤，易侵袭神经周围，治疗具有挑战性。本研究评估HN-ACC术后调强放疗（IMRT）的效果，以指导放射靶标划定，优化放射计划和改善患者预后。患者和方法：回顾性分析2015年1月至2022年12月HN-ACC患者术后IMRT结果。预防性覆盖三叉神经分支在放射场和颈结照射是基于临床/病理评估。主要终点是5年局部无复发生存期（LRRFS），次要终点包括无进展生存期（PFS）、无远处转移生存期（DMFS）和总生存期（OS）。结果：共328例患者被随访，中位时间为61.1 个月。5年LRRFS、PFS、DMFS和OS分别为91.7 %、63.0 %、67.1 %和91.3 %。局部复发30例，其中局部复发19例，局部复发6例，局部与区域合并复发5例。11例复发累及三叉神经分支（野内8例，边缘3例）。结论：HN-ACC术后IMRT，利用我们的机构靶点划定方案，优先划定沿三叉神经通路的靶点，表明有利的局部区域控制和生存结果。这些结果表明，基于证据的见解可以为临床实践提供信息，并支持放射肿瘤学家优化HN-ACC的IMRT策略。

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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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.