Takayama Kanako, Kato Takahiro, Nakamura Tatsuya, Azami Yusuke, Ono Takashi, Suzuki Motohisa, Takada Akinori, Yamaguchi Hisashi, Seto Ichiro, Nakasato Tatsuhiko, Wada Hitoshi, Kikuchi Yasuhiro, Mitsudo Kenji, Fuwa Nobukazu, Murakami Masao
Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
Cancers (Basel). 2019 Sep 22;11(10):1413. doi: 10.3390/cancers11101413.
Adenoid cystic carcinoma (ACC) is a very rare epithelial tumor of the salivary glands. Surgical resection is considered to be a standard therapy. However, the optimal treatment strategy for managing advanced cases has not yet been established. This study evaluated the efficacy and toxicity of proton beam therapy (PBT) combined with selective intra-arterial infusion chemotherapy (IAIC) using weekly cisplatin for locally advanced ACC of the base of the tongue. Between March 2009 and February 2018, 15 patients were treated. The median follow-up duration was 56 (range: 15-116) months. The 5-year local control and overall survival rates were 89% and 76%, respectively. With regard to late toxicities, grade 2 osteoradionecrosis was found in one patient and grade 5 pharyngeal necrosis was observed in one patient. Considering most cases were significantly advanced and inoperable, this therapy was effective in controlling the primary tumor, preserving function and maintaining the quality of life. Although improvements are needed to reduce adverse events, PBT in combination with IAIC can be a treatment option for locally advanced ACC of the base of the tongue.
腺样囊性癌（ACC）是一种非常罕见的涎腺上皮性肿瘤。手术切除被认为是标准治疗方法。然而，对于晚期病例的最佳治疗策略尚未确立。本研究评估了质子束治疗（PBT）联合每周使用顺铂的选择性动脉内灌注化疗（IAIC）对舌根部局部晚期ACC的疗效和毒性。2009年3月至2018年2月，共治疗了15例患者。中位随访时间为56（范围：15 - 116）个月。5年局部控制率和总生存率分别为89%和76%。关于晚期毒性，1例患者出现2级放射性骨坏死，1例患者出现5级咽部坏死。考虑到大多数病例病情严重且无法手术，该治疗方法在控制原发肿瘤、保留功能和维持生活质量方面有效。尽管需要改进以减少不良事件，但PBT联合IAIC可作为舌根部局部晚期ACC的一种治疗选择。
