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Tumor growth rate as a prognostic factor for metastatic or recurrent adenoid cystic carcinoma of the head and neck patients treated with carboplatin plus paclitaxel

European Archives of Oto-Rhino-Laryngology volume 278, pages 3037–3043 (2021)Cite this article

Abstract

Purpose

Large prospective studies of chemotherapy for metastatic or recurrent adenoid cystic carcinoma (ACC) of the head and neck are lacking due to the rarity of ACC. The aim of this study is to evaluate the efficacy of carboplatin plus paclitaxel toward ACC and perform an exploratory investigation of the prognostic factors to investigate the optimal strategy for metastatic or recurrent ACC.

Methods

We retrospectively analyzed recurrent or metastatic ACC patients treated with carboplatin plus paclitaxel between April 2007 and September 2019 in our hospital. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were evaluated, and an exploratory analysis of the prognostic factors was conducted.

Results

A total of 26 ACC patients were enrolled. ORR and DCR were 11.5 and 76.9%; the median PFS and OS were 8.1 and 22.3 months, respectively. From the results of the multivariate analysis, higher (≥ 6%/month) tumor growth rate (TGR) was associated with worse PFS (hazard ratio [HR] 7.00, 95% CI 1.34–36.53, p = 0.02) and OS (HR 29.33, 95% CI 3.38–254.80, p < 0.01). The median PFS (10.6 vs. 6.6 months, log-rank p < 0.05) and OS (48.5 vs. 16.9 months, log-rank p < 0.01) were significantly shorter in patients with higher TGR.

Conclusions

Carboplatin plus paclitaxel showed modest efficacy for recurrent or metastatic ACC patients. Watchful waiting may be optimal for ACC patients with lower TGR. Systemic chemotherapy should be considered when TGR increases during active surveillance.

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Acknowledgments

We thank all members of the Department of Head and Neck Oncology at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research for patient referral. We also thank the members of the Department of Pathology at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research for their assistance in patient diagnosis.

Funding

This research was not supported by a specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Affiliations

  1. Department of Medical Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Naoki Fukuda, Yu Fujiwara, Xiaofei Wang, Akihiro Ohmoto, Tetsuya Urasaki, Naomi Hayashi, Yasuyoshi Sato, Kenji Nakano, Mayu Yunokawa, Makiko Ono, Junichi Tomomatsu & Shunji Takahashi

Authors
  1. Naoki Fukuda
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  2. Yu Fujiwara
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Contributions

NF wrote the manuscript; YF, XW, AO, TU, NH, YS, KN, MY, MO, JT, and ST contributed critical revisions to the manuscript.

Corresponding author

Correspondence to Naoki Fukuda.

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Conflict of interest

The authors declare that they have no conflict of interest related to this work.

Ethics approval

This study was approved by the institutional review board of the Cancer Institute Hospital of the Japanese Foundation for Cancer Research (No. 2019-1219). This study was conducted in accordance with the Helsinki Declaration of 1964 and later versions.

Consent to participate

Due to the retrospective nature of this study, the requirement for informed consent from the patients was waived by our hospital's institutional review board.

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Fukuda, N., Fujiwara, Y., Wang, X. et al. Tumor growth rate as a prognostic factor for metastatic or recurrent adenoid cystic carcinoma of the head and neck patients treated with carboplatin plus paclitaxel. Eur Arch Otorhinolaryngol 278, 3037–3043 (2021). https://doi.org/10.1007/s00405-020-06481-y

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  • DOI: https://doi.org/10.1007/s00405-020-06481-y

Keywords

  • Head and neck neoplasms
  • Carcinoma
  • Adenoid cystic
  • Chemotherapy
  • Prognostic factor