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Role of postoperative radiation therapy in patients with adenoid cystic carcinoma: a SEER analysis

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

Adenoid cystic carcinoma (ACC) is a rare malignancy affecting the exocrine glands. Management is surgery plus or minus adjuvant radiation (RT). No prospective study of RT for resected ACC has been reported. We hypothesized that adjuvant RT might improve survival.

Methods and materials

The Surveillance, Epidemiology and End Results Database (SEER) database was queried for ACC cases from 1988 to 2010 (n = 3427). A univariate analysis of survival by whether RT was received, and several demographic, staging, and treatment-related factors were performed using Kaplan–Meier survival curves and log–rank tests. Local control rate could not be adequately assessed.

Results

There were 2090 patients who received adjuvant RT and 1337 who did not. The 10-year cause-specific survival for localized disease was 90 % (95 % CI (87 %, 92 %)) for no radiation versus 89 % (95 % CI (86 %, 92 %)) for RT, indicating no survival difference(p = 0.32). In a multivariate model, there was an increased risk of cause-specific death associated with RT for regional nodal disease (HR 1.50, p = 0.003) and a decreased risk for cause-specific death in metastatic disease (HR 0.68, p = 0.043). In a multivariate model, there was an increased risk of death associated with RT for regional disease (HR 1.24, p = 0.044), and a trend for decreased risk of death associated with RT for metastatic disease (HR 0.74, p = 0.073).

Conclusion

This SEER review found no evidence of survival benefit for adjuvant RT for local ACC. A worsened survival for regional ACC suggests a selection bias toward use of RT in higher risk patients. Prospective studies of adjuvant RT in ACC are needed.

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Acknowledgments

We thank the University of Virginia Cancer Center for support of this research.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Virginia, PO Box 800466, Charlottesville, VA, 22908, USA

    Prashant Joshi

  2. Department of Health Sciences, University of Virginia, PO Box 800717, Charlottesville, VA, 22908-0717, USA

    Mark E. Smolkin

  3. Department of Hematology-Oncology, University of Virginia, PO Box 800716, Charlottesville, VA, 22908-0716, USA

    Patrick Dillon

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  1. Prashant Joshi
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Correspondence to Patrick Dillon.

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Conflict of interest

Prashant Joshi declares no conflict of interest. Mark Smolkin declares no conflict of interest. Patrick Dillon declares no conflict of interest.

Funding

Patrick Dillon received funding from the University of Virginia Cancer Center to support this project.

Human Research

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Joshi, P., Smolkin, M.E. & Dillon, P. Role of postoperative radiation therapy in patients with adenoid cystic carcinoma: a SEER analysis. J Radiat Oncol 5, 153–159 (2016). https://doi.org/10.1007/s13566-015-0234-3

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  • DOI: https://doi.org/10.1007/s13566-015-0234-3

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