Polanowski Paweł, Księżniak-Baran Dorota, Grządziel Aleksandra, Pietruszka Agnieszka, Chmielik Ewa, Pilecki Bolesław, Amrogowicz Natalia, Gajda Karolina, Składowski Krzysztof
1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland.
Radiotherapy Planning Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland.
Case Rep Oncol. 2021 Mar 9;14(1):371-377. doi: 10.1159/000512069. eCollection 2021 Jan-Apr.
Adenoid cystic carcinoma (ACC) should be treated with a surgical procedure. Unfortunately, in some cases, such procedures are impossible to perform. In that event, radiotherapy can be used as a form of radical treatment, although ACC is established as a radio- and chemoresistant tumour. Therefore, unconventional fractionated radiotherapy needs to be considered.
Here, we present a case study of a patient with an unresectable tumour of the choanae and nasopharynx treated with a stereotactic radiotherapy boost in combination with conventional radiotherapy. We achieved complete clinical regression after application of a 1 × 18 Gy boost followed by conventional radiotherapy at 50 Gy in 25 fractions. The early and late tolerance of this treatment were positive. During the 2-year follow-up, local and distant recurrence were not detected.
This case represents an individualized, modern and safe approach to unresectable ACC. This is one of the first cases to show the use of a combination of stereotactic and conventional radiotherapy in radical, conservative cancer treatment.
腺样囊性癌（ACC）应采用外科手术治疗。不幸的是，在某些情况下，无法进行此类手术。在这种情况下，放疗可作为一种根治性治疗方式，尽管ACC被认为是一种对放疗和化疗耐药的肿瘤。因此，需要考虑采用非常规分割放疗。
在此，我们展示了一例患有不可切除的后鼻孔和鼻咽肿瘤患者的病例研究，该患者接受了立体定向放疗增敏联合传统放疗。在给予1×18 Gy的增敏剂量后，接着进行25次分割、总剂量50 Gy的传统放疗，我们实现了完全临床缓解。该治疗的早期和晚期耐受性良好。在2年的随访期间，未检测到局部和远处复发。
该病例代表了一种针对不可切除ACC的个体化、现代且安全的治疗方法。这是首批展示在根治性、保守性癌症治疗中使用立体定向放疗与传统放疗相结合的病例之一。
