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Concurrent chemoradiotherapy for locally advanced unresectable adenoid cystic carcinoma of head and neck: experience from a single institute

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Abstract

Purpose

To analyze the outcome of locally advanced unresectable adenoid cystic carcinoma (ACC) of head and neck treated with radical concurrent chemoradiotherapy (CRT) at a single tertiary care centre.

Methods

Between 2011 and 2018, 23 patients with locally advanced unresectable ACC of head and neck treated with non-surgical radical treatment with concurrent chemoradiotherapy were evaluated for outcome and toxicity. All but one patient received cisplatin-based concurrent chemotherapy and 74% of patients were treated with intensity-modulated radiotherapy.

Results

Median follow-up was 53 months (range 3–115 months). Following treatment, 11 patients achieved complete response (47.8%) and of the 12 patients with residual disease, 7 patients additionally had disease stabilization without local progression. Overall 15 patients had disease progression. Median time to progression was 28 months (range 6–67 months). The 3-year and 5-year overall survival, local progression-free survival (LPFS) and distant progression-free survival (DPFS) were 78%, 79.7%, 67.4% and 63%, 50.9%, 48.6%, respectively. Acute grade 3 mucositis was observed in three patients, and one patient additionally developed grade 4 neutropenia with subsequent complete recovery. No grade 3 or higher late toxicity was observed.

Conclusion

Radical concurrent chemoradiotherapy is a promising treatment option in locally advanced unresectable ACC with acceptable toxicity.

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Data availability

All data analyzed during this study are included in this manuscript.

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Authors and Affiliations

  1. Department of Radiation Oncology, Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Dr. E. Borges Road, Parel, Mumbai, Maharashtra, 400012, India

    Monali Swain, Sarbani Ghosh-Laskar, Ashwini Budrukkar, Roshan Patil, Naveen Mummudi & Jai Prakash Agarwal

  2. Department of Radiation Oncology, Advanced Centre for Treatment Research and Education for Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India

    Vedang Murthy & Tejpal Gupta

  3. Department of Medical Oncology, Tata Memorial Hospital (TMH), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India

    Kumar Prabhash, Amit Joshi, Vijay Maruti Patil & Vanita Naronha

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  1. Monali Swain
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  2. Sarbani Ghosh-Laskar
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Correspondence to Monali Swain.

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Swain, M., Ghosh-Laskar, S., Budrukkar, A. et al. Concurrent chemoradiotherapy for locally advanced unresectable adenoid cystic carcinoma of head and neck: experience from a single institute. Eur Arch Otorhinolaryngol 278, 4423–4431 (2021). https://doi.org/10.1007/s00405-021-06654-3

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