Three-year results after radiotherapy for locally advanced sinonasal adenoid cystic carcinoma, using highly conformational radiotherapy techniques proton therapy and/or Tomotherapy

Cancer Radiother. 2018 Sep;22(5):411-416. doi: 10.1016/j.canrad.2017.11.015. Epub 2018 Jul 29.

Abstract

Purpose: We report the patient outcomes of a treatment combining proton therapy and Tomotherapy in sinonasal adenoid cystic carcinoma involving skull base.

Materials and methods: We included patients treated at Curie Institute, Paris, France, between March 2010 and February 2014 for an advanced adenoid cystic carcinoma involving skull base. Patients received Tomotherapy, proton therapy or both. We evaluated treatment toxicity (according to CTCAE V4), local control, distant metastasis-free survival and overall survival.

Results: Thirteen patients were included, with a median follow-up of 34 months. Radiation therapy followed surgery for 77% of the patients and margins were positive in all those cases. Median dose was 73.8Gy. Local control, distant metastasis-free survival and overall survival at 3 years were respectively 60%, 48% and 60%. One-sided grade 3 hearing impairment occurred in 46% of the patients.

Conclusion: Combining high-dose proton therapy and Tomotherapy is effective and has moderate toxicity in the treatment of T4 sinonasal adenoid cystic carcinoma involving skull base.

Keywords: Adenoid cystic carcinoma; Carcinome adénoïde kystique; Proton therapy; Protonthérapie; Radiotherapy; Radiothérapie; Reirradiation; Tomotherapy; Tomothérapie: Réirradiation.

MeSH terms

  • Carcinoma, Adenoid Cystic / diagnostic imaging
  • Carcinoma, Adenoid Cystic / mortality
  • Carcinoma, Adenoid Cystic / radiotherapy*
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Organs at Risk / diagnostic imaging
  • Paranasal Sinus Neoplasms / diagnostic imaging
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / radiotherapy*
  • Proton Therapy*
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Radiotherapy, Conformal*
  • Radiotherapy, Image-Guided
  • Radiotherapy, Intensity-Modulated*
  • Retrospective Studies
  • Skull Base Neoplasms / diagnostic imaging
  • Skull Base Neoplasms / mortality
  • Skull Base Neoplasms / radiotherapy*