碳离子放疗治疗头颈部腺样囊性癌的预后因素：组织学亚型的影响

Prognostic factors of adenoid cystic carcinoma of the head and neck in carbon-ion radiotherapy: The impact of histological subtypes.

作者信息

Ikawa Hiroaki, Koto Masashi, Takagi Ryo, Ebner Daniel K, Hasegawa Azusa, Naganawa Kensuke, Takenouchi Toshinao, Nagao Toshitaka, Nomura Takeshi, Shibahara Takahiko, Tsuji Hiroshi, Kamada Tadashi

机构信息

Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan; Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Japan.

Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan.

出版信息

Radiother Oncol. 2017 Jun;123(3):387-393. doi: 10.1016/j.radonc.2017.04.026. Epub 2017 May 18.

DOI:10.1016/j.radonc.2017.04.026

PMID:28528680

Abstract

PURPOSE

The aim of this study was to evaluate the effect of histological subtypes of head and neck adenoid cystic carcinoma (ACC) on the results of carbon-ion radiotherapy (CIRT).

MATERIAL AND METHODS

Of the 113 patients with ACC who were treated with CIRT between December 2006 and July 2013, 100 patients with identified histological subtypes were enrolled in this study. CIRT at a total dose of 57.6 or 64.0Gy (RBE) was administered in 16 fractions. Histological grading was defined as the presence or absence of a solid growth pattern.

RESULTS

Median follow-up was 60 months. 5-Year local control (LC), overall survival (OS) and distant metastasis free survival (DMFS) of all patients were 68.6%, 74.8% and 65.7%, respectively. On multivariate analysis, the prescribed dose (p=0.001) and gross tumor volume (p=0.002) were significant independent risk factors for LC. No significant difference for local control of solid/non-solid growth patterns was found (p=0.093). Solid growth pattern was an independent risk factor for both OS (p=0.033) and DMFS (p=0.024).

CONCLUSIONS

CIRT appears able to locally control solid growth pattern ACC in the head and neck. Improved intervention is needed to extend DMFS and OS.

摘要

目的

本研究旨在评估头颈部腺样囊性癌（ACC）的组织学亚型对碳离子放射治疗（CIRT）效果的影响。

材料与方法

2006年12月至2013年7月期间接受CIRT治疗的113例ACC患者中，100例具有明确组织学亚型的患者纳入本研究。以16次分割给予总剂量为57.6或64.0Gy（RBE）的CIRT。组织学分级定义为是否存在实体生长模式。

结果

中位随访时间为60个月。所有患者的5年局部控制率（LC）、总生存率（OS）和无远处转移生存率（DMFS）分别为68.6%、74.8%和65.7%。多因素分析显示，处方剂量（p = 0.001）和肿瘤总体积（p = 0.002）是LC的显著独立危险因素。实体/非实体生长模式的局部控制无显著差异（p = 0.093）。实体生长模式是OS（p = 0.033）和DMFS（p = 0.024）的独立危险因素。