Korean J Intern Med.  2021 Jan;36(1):175-181. 10.3904/kjim.2019.104.

Role of concurrent chemoradiation on locally advanced unresectable adenoid cystic carcinoma

Affiliations
  • 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 2Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
  • 3Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
  • 4Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
  • 5Department of Otorhinolaryngology, Seoul National University Hospital, Seoul, Korea

Abstract

Background/Aims
Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor characterized by indolence, with a high rate of local recurrence and distant metastasis. This study aimed to investigate the effect of concurrent chemoradiation (CCRT) on locally advanced unresectable ACC.
Methods
We retrospectively analyzed clinical data from 10 patients with pathologically confirmed ACC of the head and neck who received CCRT with cisplatin in Seoul National University Hospital between 2013 and 2018.
Results
Ten patients with unresectable disease at the time of diagnosis or with positive margins after surgical resection received CCRT with weekly cisplatin. Eight patients (80%) achieved complete remission, of which three later developed distant metastases without local relapse; one patient developed distant metastasis and local relapse. Two patient achieved partial remission without progression. Patients experienced several toxicities, including dry mouth, radiation dermatitis, nausea, and salivary gland inflammation of mostly grade 1 to 2. Only one patient showed grade 3 oral mucositis. Median relapse-free survival was 34.5 months (95% confidence interval, 22.8 months to not reached).
Conclusions
CCRT with cisplatin is effective for local control of ACC with manageable toxicity and may be an effective treatment option for locally advanced unresectable ACC.

Keyword

Carcinoma; adenoid cystic; Chemoradiotherapy; Cisplatin
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