Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, 201321, China.
Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201321, China.
BMC Cancer. 2021 Jun 26;21(1):734. doi: 10.1186/s12885-021-08493-1.
Tracheobronchial adenoid cystic carcinoma (TACC) is a rare tumour. About one-third of patients miss their chance of surgery or complete resection as it is mostly detected in the advanced stage; hence, photon radiotherapy (RT) is used. However, the outcomes of photon RT remain unsatisfactory. Carbon ion radiotherapy (CIRT) is thought to improve the therapeutic gain ratio; however, the outcomes of CIRT in TACC are unclear. Therefore, we aimed to assess the effects and toxicities of CIRT in patients with TACC.
The inclusion criteria were as follows: 1) age 18-80 years; 2) Eastern Cooperative Oncology Group Performance Status 0-2; 3) histologically confirmed TACC; 4) stage III-IV disease; 5) visible primary tumour; and 6) no previous RT history. The planned prescription doses of CIRT were 66-72.6 GyE/22-23 fractions. The rates of overall survival (OS), local control (LC), and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Treatment-induced toxicities and tumour response were scored according to the Common Terminology Criteria for Adverse Events and Response Evaluation Criteria in Solid Tumors, respectively.
Eighteen patients with a median age of 48 (range 30-73) years were enrolled. The median follow-up time was 20.7 (range 5.8-44.1) months. The overall response rate was 88.2%. Five patients developed lung metastasis after 12.2-41.0 months and one of them experienced local recurrence at 31.9 months after CIRT. The rates of 2-year OS, LC, and PFS were 100, 100, and 61.4%, respectively. Except for one patient who experienced grade 4 tracheal stenosis, which was relieved after stent implantation, no other ≥3 grade toxicities were observed.
CIRT might be safe and effective in the management of TACC based on a short observation period. Further studies with more cases and longer observation are warranted.
气管支气管腺样囊性癌（TACC）是一种罕见的肿瘤。由于大多数 TACC 在晚期被发现，约三分之一的患者错过了手术或完全切除的机会；因此，光子放疗（RT）被用于治疗。然而，光子 RT 的疗效仍不理想。碳离子放疗（CIRT）被认为可以提高治疗增益比；然而，CIRT 治疗 TACC 的效果尚不清楚。因此，我们旨在评估 CIRT 治疗 TACC 患者的疗效和毒性。
纳入标准如下：1）年龄 18-80 岁；2）东部肿瘤协作组体能状态 0-2 分；3）组织学证实为 TACC；4）III-IV 期疾病；5）可见原发性肿瘤；6）无既往 RT 史。计划 CIRT 的处方剂量为 66-72.6 GyE/22-23 分次。采用 Kaplan-Meier 法计算总生存率（OS）、局部控制率（LC）和无进展生存率（PFS）。根据不良事件通用术语标准和实体瘤反应评价标准分别对治疗诱导的毒性和肿瘤反应进行评分。
共纳入 18 例患者，中位年龄为 48 岁（范围 30-73 岁）。中位随访时间为 20.7 个月（范围 5.8-44.1 个月）。总体缓解率为 88.2%。5 例患者在 12.2-41.0 个月后发生肺转移，其中 1 例在 CIRT 后 31.9 个月出现局部复发。2 年 OS、LC 和 PFS 率分别为 100%、100%和 61.4%。除 1 例患者发生 4 级气管狭窄，经支架植入后缓解外，未观察到其他≥3 级毒性。
在短期观察期内，CIRT 治疗 TACC 可能是安全有效的。需要进一步开展更多病例和更长时间观察的研究。
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