The Role of Radiation Therapy in the Treatment of Adenoid Cystic Carcinoma of the Head and Neck / 대한치료방사선과학회지

ABSTRACT

Forty eight patients with adenoid cystic carcinoma(ACC) in the head and beck treated between 1979 and 1990 were reviewed according to treatment modalities and clinical courses. The common site of origin was minor salivary gland (69%), mostly had palate and maxillary sinus. 11 patients received radiation therapy(RT) alone and 37 patients received combined surgery and radiation therapy. The follow-up period of the survivors ranged from 4 to 118 months (median 49.5 months). The 5 year local control rate was 69.3%, 67.3% and 83.9% in RT alone, conservative operation(OP)+RT and radical OP+RT group, respectively(p>0.05). The control of local disease was best achieved with radical OP+RT. In postoperative RT, high dose (> or =60 Gy) and generous field size (> 64cml) yielded a better local control rate. Actuarial overall survival rate was 79.0%, at 5 years and 19.2% at 10 years. Distant metastases (DM) developed in 40% of patients, mostly in the lung. Disease-free(NED) survival rate was 45.8%, at 5 years and significant differences did not exist according to primary sites and treatment options. Survival rate after the onset of DM was 19.5% at 5 years. Occurrence of DM tends to lower survival significantly. In an effort to find the role of RT in the treatment of ACC, our data suggest that a well-planned postoperative RT employing a high dose and generous field size can produce high local control rate and remaining urgent problem of distant metastasis demands more effective chemotherapy for the purpose of improving survival of ACC patients.