Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Korean J Intern Med. 2021 Jan;36(1):175-181. doi: 10.3904/kjim.2019.104. Epub 2020 Mar 30.
BACKGROUND/AIMS: Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor characterized by indolence, with a high rate of local recurrence and distant metastasis. This study aimed to investigate the effect of concurrent chemoradiation (CCRT) on locally advanced unresectable ACC.
We retrospectively analyzed clinical data from 10 patients with pathologically confirmed ACC of the head and neck who received CCRT with cisplatin in Seoul National University Hospital between 2013 and 2018.
Ten patients with unresectable disease at the time of diagnosis or with positive margins after surgical resection received CCRT with weekly cisplatin. Eight patients (80%) achieved complete remission, of which three later developed distant metastases without local relapse; one patient developed distant metastasis and local relapse. Two patient achieved partial remission without progression. Patients experienced several toxicities, including dry mouth, radiation dermatitis, nausea, and salivary gland inflammation of mostly grade 1 to 2. Only one patient showed grade 3 oral mucositis. Median relapse-free survival was 34.5 months (95% confidence interval, 22.8 months to not reached).
CCRT with cisplatin is effective for local control of ACC with manageable toxicity and may be an effective treatment option for locally advanced unresectable ACC.
背景/目的：腺样囊性癌（ACC）是一种罕见的唾液腺肿瘤，其特征为惰性，局部复发率和远处转移率均较高。本研究旨在探讨同期放化疗（CCRT）对局部晚期不可切除 ACC 的疗效。
我们回顾性分析了 2013 年至 2018 年期间在首尔国立大学医院接受顺铂 CCRT 的 10 例经病理证实的头颈部 ACC 患者的临床资料。
10 例患者在诊断时为不可切除疾病或手术切除后边缘阳性，接受了每周顺铂 CCRT。8 例患者（80%）达到完全缓解，其中 3 例后来发生远处转移而无局部复发；1 例发生远处转移和局部复发。2 例患者达到部分缓解而无进展。患者经历了多种毒性反应，包括口干、放射性皮炎、恶心和唾液腺炎，大多为 1 至 2 级。只有 1 例患者出现 3 级口腔黏膜炎。中位无复发生存期为 34.5 个月（95%置信区间，22.8 个月至未达到）。
顺铂 CCRT 对 ACC 的局部控制有效，毒性可管理，可能是局部晚期不可切除 ACC 的有效治疗选择。
