Adenoid cystic carcinoma of the head and neck: Patterns of recurrence and implications for intensity‐modulated radiotherapy

• Published in: Head & neck Vol. 45; no. 1; pp. 187 - 196
• Main Authors: Gao, Robert W., Routman, David M., Harmsen, William S., Ebrahimi, Sasha, Foote, Robert L., Ma, Daniel J., Neben‐Wittich, Michelle, McGee, Lisa A., Patel, Samir H., Moore, Eric J., Choby, Garret W., Tasche, Kendall K., Price, Katharine A., Gamez, Mauricio E., Lester, Scott C.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.01.2023; Wiley Subscription Services, Inc
• Subjects: Adenoid; adenoid cystic carcinoma; adjuvant radiotherapy; Carcinoma, Adenoid Cystic - pathology; Carcinoma, Adenoid Cystic - radiotherapy; Carcinoma, Adenoid Cystic - surgery; conformal radiotherapy; Head & neck cancer; Head and neck carcinoma; head and neck neoplasms; Head and Neck Neoplasms - radiotherapy; Head and Neck Neoplasms - surgery; Humans; intensity‐modulated radiotherapy; Neoplasm Recurrence, Local - epidemiology; Radiation therapy; Radiotherapy, Conformal - methods; Radiotherapy, Intensity-Modulated; Retrospective Studies; head and neck neoplasms; conformal radiotherapy; intensity-modulated radiotherapy; adjuvant radiotherapy; adenoid cystic carcinoma
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.27223

Background We seek to inform radiotherapy (RT) delivery for adenoid cystic carcinoma of the head and neck (ACC) by evaluating RT techniques and recurrence patterns. Methods We identified patients with ACC treated with curative‐intent RT from 2005 to 2021. Imaging was reviewed to determine local recurrence (LR). Results Ninety‐one patients were included. The 5‐year LR risk was 12.2% (6.6–22.7). One patient each experienced a marginal and out‐of‐field recurrence. Patients receiving >60 Gy postoperatively had a 5‐year LR risk of 0% compared to 10.7% (4.2–27.2) with ≤60 Gy. Those receiving 70 and <70 Gy definitively had a 5‐year LR risk of 15.2% (2.5–91.6) and 33.3% (6.7–100.0), respectively. No patients had regional nodal failure. Conclusions Modern, conformal RT for ACC results in low rates of LR. Doses >60 and 70 Gy may improve control in the postoperative and definitive settings, respectively. Elective nodal treatment can be omitted in well‐selected patients.