Radiotherapy for advanced adenoid cystic carcinoma: neutrons, photons or mixed beam?

摘要: Abstract Purpose : To compare retrospectively radiotherapy with neutrons, photons, and a photon/neutron mixed beam in patients advanced adenoid cystic carcinoma of the head neck. Local control, survival, distant failure, complications were analyzed. Materials methods Between 1983 1995, 75 inoperable, recurrent, or incompletely resected neck received that consisted either fast 14.1 MV DT neutrons (median dose 16 neutron Gy), linac-based photon irradiation 64 both 8 Gy 32 Gy). Follow-up ranged from 1 to 160 months 51 months), surviving had minimum follow-up 3 years at time analysis. Results The actuarial 5-year local control was 75% for 32% photons ( P =0.015, log-rank). This advantage not transferred significant differences survival >0.1). is dictated by tumor diseases due metastases occurring 29 (39%) patients. Positive lymph nodes only factor =0.001) associated development although negative did predict absence metastases, but predicted delay occurrence. In multivariate analysis postoperative =0.003) small size =0.01) high while primary therapy =0.006) longer survival. While acute toxicity similar all three groups, severe late grade 4 tended be more prevalent >0.1) (19%) than (10%) (4%). Conclusion Fast provides higher rates advanced, recurrent completely major minor salivary glands. Neutron can recommended bad prognosis gross residual disease (R2), unresectable tumors, inoperable tumors. type radiation does impact which dominated number metastases.