Abstract

Purpose

Due to the rarity of adenoid cystic carcinoma (ACC) of the major salivary gland, there is no consensus on the extent of prophylactic neck irradiation (PNI) for patients with clinically negative lymph nodes (cN0) disease.

Materials and methods

We conducted a retrospective analysis of all patients with ACC of the major salivary gland who received treatment at our center between January 2010 and April 2020. The primary endpoint was regional failure-free survival (RRFS). Secondary endpoints included overall survival (OS), distant metastasis-free survival (DMFS), local recurrence-free survival (LRFS), and acute toxicity.

Results

A total of 139 patients were included in the analysis. For cN0 patients, the 5-year RRFS, OS, DMFS, and LRFS were 93.2%, 90.2%, 75.7%, and 91.4%, respectively. Multivariate analysis revealed that PORT was an independent prognostic factor for RRFS and LRFS. No statistically significant differences were observed between the Level III sparing PNI group and the Standard PNI group in terms of RRFS, OS, DMFS, and LRFS. The doses delivered to the larynx and thyroid in the Level III sparing PNI group were significantly lower than those in the Standard PNI group.

Conclusion

In patients with cN0 ACC of the major salivary gland, PNI improves regional control, and the level III nodal region sparing radiotherapy does not increase the risk of level III recurrence, while potentially reducing toxicity.

中文翻译：

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cN0 大唾液腺腺样囊性癌患者省略 III 级淋巴结放疗：单中心经验

摘要

目的

由于大唾液腺腺样囊性癌（ACC）罕见，对于临床阴性淋巴结（cN0）疾病患者的预防性颈部照射（PNI）范围尚未达成共识。

材料和方法

我们对 2010 年 1 月至 2020 年 4 月期间在我们中心接受治疗的所有大唾液腺 ACC 患者进行了回顾性分析。主要终点是区域无失败生存期 (RRFS)。次要终点包括总生存期（OS）、无远处转移生存期（DMFS）、局部无复发生存期（LRFS）和急性毒性。

结果

总共 139 名患者被纳入分析。对于cN0患者，5年RRFS、OS、DMFS和LRFS分别为93.2%、90.2%、75.7%和91.4%。多变量分析显示，PORT 是 RRFS 和 LRFS 的独立预后因素。 III 级保留 PNI 组和标准 PNI 组在 RRFS、OS、DMFS 和 LRFS 方面没有观察到统计学上的显着差异。 III级保留PNI组中递送至喉部和甲状腺的剂量显着低于标准PNI组。

结论

在大唾液腺 cN0 ACC 患者中，PNI 改善了区域控制，并且 III 级淋巴结区域保留放疗不会增加 III 级复发的风险，同时可能降低毒性。