Outcomes and prognostic variables in adenoid cystic carcinoma of the head and neck: A recent experience Journal Article

Authors: Gomez, D. R.; Hoppe, B. S.; Wolden, S. L.; Zhung, J. E.; Patel, S. G.; Kraus, D. H.; Shah, J. P.; Ghossein, R. A.; Lee, N. Y.
Article Title: Outcomes and prognostic variables in adenoid cystic carcinoma of the head and neck: A recent experience
Abstract: Purpose: To analyze the recent experience of patients with adenoid cystic carcinoma treated with radiation therapy at Memorial Sloan-Kettering Cancer Center. Methods and Materials: From 1990 to 2004, a total of 59 patients with a diagnosis of primary adenoid cystic carcinoma of the head and neck received radiation therapy at our institution. The subsite distribution was oral cavity, 28% (n = 17); paranasal sinuses, 22% (n = 13); parotid, 14% (n = 8); submandibular, 14% (n = 8); oropharynx, 10% (n = 6); sublingual, 3% (n = 2); nasopharynx, 3% (n = 2); and other, 5% (n = 3). T Stage distribution was T1, 34% (n = 20); T2, 19% (n = 11); T3, 14% (n = 8); and T4, 34% (n = 20). Twenty-nine percent of patients (n = 17) were treated with intensity-modulated radiation therapy; 25% (n =15), with three-dimensional conformal therapy, and the remainder, with conventional techniques. Ninety percent (n = 53) of patients received treatment including the base of skull. Results: Median follow-up for surviving patients was 5.9 years. Five-year and 10-year rates of local control and distant metastases-free survival were 91%/81% and 81%/49%, respectively. Five-year and 10-year rates of disease-free and overall survival were 76%/40% and 87%/65%, respectively. On univariate analysis, stage T4 (p = 0.004) and gross/clinical nerve involvement (p = 0.002) were associated with decreased progression free survival, whereas stage T4 and lymph node involvement were associated with decreased overall survival (p = 0.046 and p < 0.001, respectively). Conclusions: Radiation therapy in combination with surgery produces excellent rates of local control, although distant metastases account for a high proportion of failures. Routine treatment to the base of skull reduces the significance of histologic perineural invasion, but major nerve involvement remains an adverse prognostic factor. © 2008 Elsevier Inc. All rights reserved.
Keywords: adolescent; adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; treatment failure; retrospective studies; major clinical study; intensity modulated radiation therapy; laryngectomy; cisplatin; paclitaxel; cancer staging; nuclear magnetic resonance imaging; follow up; lymphatic metastasis; carboplatin; computer assisted tomography; neoplasm recurrence, local; mucosa inflammation; radiotherapy; combination chemotherapy; cyclophosphamide; oncology; histology; head and neck cancer; head and neck neoplasms; radiation injuries; surgery; oropharynx cancer; salivary gland disease; salivary gland; salivary gland tumor; salivary glands; dermatitis; radiotherapy, conformal; adenoid cystic carcinoma; disease control; analysis of variance; tissue engineering; head and neck; paranasal sinus cancer; carcinoma, adenoid cystic; esophagus disease; mouth cancer; eye toxicity; lhermitte duclos disease; perineural invasion; spinal cord disease; adenoid cystic; t stage; auditory tube dysfunction; ear disease; palate disease; parotid gland cancer
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 70
Issue: 5
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2008-04-01
Start Page: 1365
End Page: 1372
Language: English
DOI: 10.1016/j.ijrobp.2007.08.008
PUBMED: 18029108
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 16" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Dennis Kraus
    268 Kraus
  2. Ronald A Ghossein
    367 Ghossein
  3. Suzanne L Wolden
    485 Wolden
  4. Snehal G Patel
    342 Patel
  5. Daniel R Gomez
    84 Gomez
  6. Nancy Y. Lee
    695 Lee
  7. Bradford Scott Hoppe
    14 Hoppe
  8. Jatin P Shah
    643 Shah
  9. Joanne Zhung
    12 Zhung