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Post-operative accelerated hypofractionated radiotherapy for adenoid cystic carcinoma

Published online by Cambridge University Press:  12 November 2010

Jennifer Sherriff
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK
Urmila Barthakur
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK
Paul Sanghera*
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK Division of Cancer Studies, University of Birmingham, Birmingham, UK
Christopher McConkey
Affiliation:
Clinical Trial Unit, University of Warwick, Coventry, UK
Christopher Rusius
Affiliation:
Medical School, University of Birmingham, Birmingham, UK
Andrew Hartley
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK Division of Cancer Studies, University of Birmingham, Birmingham, UK
John Glaholm
Affiliation:
Hall-Edwards Radiotherapy Research Group, Cancer Centre, Queen Elizabeth Hospital, Birmingham, UK Division of Cancer Studies, University of Birmingham, Birmingham, UK
*
Correspondence to: Paul Sanghera, Cancer Centre, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK. E-mail: paul.sanghera@uhb.nhs.uk

Abstract

Objective: To examine the outcomes of patients with adenoid cystic carcinoma (ACC) treated with post-operative accelerated hypofractionated radiotherapy (AHRT).

Methods: Patients treated with AHRT (50–55 Gy in 20 fractions over 25 days) between 1997 and 2008 were identified and retrospectively analysed. Data collection included site of primary and surgical excision margin. Primary outcomes were overall survival (OS) and local control (LC) calculated using the Kaplan–Meier method.

Results: A total of 37 patients meeting the above criteria were identified with a median age of 55 years (range 31–79). Distribution by anatomical site was as follows: parotid 9 patients; submandibular gland 8 patients; other salivary gland tissue 20 patients. Surgical excision margins were as follows: non-involved 25 patients; microscopic involvement 7 patients; macroscopic involvement 4 patients; unknown 1 patient. Median follow-up was 59 (range 14–126) months. Five patients had local recurrence, 4 distant recurrences, and 1 both local and distant recurrence. The 5-year LC and OS rates were 81.8% (95% confidence intervals (CIs) 60.9–92.2) and 78.5% (95% CI 58.0–89.8%), respectively.

Conclusion: Outcomes with post-operative AHRT appear comparable to those in the literature. However, until more is known about the radiobiology of this rare disease, a biological equivalent of 60 Gy in 2 gray fractions without correction for accelerated repopulation should be used.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2010

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