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      Bimodality treatment of patients with pelvic adenoid cystic carcinoma with photon intensity-modulated radiotherapy plus carbon ion boost: a case series

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          Abstract

          Background

          Treatment of patients with pelvic adenoid cystic carcinoma (ACC) remains a challenge owing to the rarity of the disease, the lack of data, and the relative radioresistance of these tumors.

          Case reports

          This case series presents the results of three patients with recurrent or inoperable pelvic ACC treated with intensity-modulated radiotherapy (IMRT) plus carbon ion (C12) boost. Patients received C12 therapy at a dose of 3 Gray equivalents (GyE) (relative biological effectiveness [RBE]) per fraction up to 24 GyE RBE, followed by 50 GyE of photon IMRT in 25 fractions.

          Conclusion

          IMRT plus C12 ion boost as a definitive or adjuvant treatment for pelvic ACCs seems to be a promising therapeutic option. No unexpected toxicity was detected and the observed toxicity remained consistently low. The initial treatment response is promising and similar to that experienced for head and neck ACCs.

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          Most cited references26

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          Use of normal tissue complication probability models in the clinic.

          Lawrence Marks, Ellen D Yorke, Andrew Jackson … (2010)
          The Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) review summarizes the currently available three-dimensional dose/volume/outcome data to update and refine the normal tissue dose/volume tolerance guidelines provided by the classic Emami et al. paper published in 1991. A "clinician's view" on using the QUANTEC information in a responsible manner is presented along with a description of the most commonly used normal tissue complication probability (NTCP) models. A summary of organ-specific dose/volume/outcome data, based on the QUANTEC reviews, is included. Copyright 2010 Elsevier Inc. All rights reserved.
          Article 0 comments Cited 417 times – based on 0 reviews     Review now
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            Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues.

            Søren Bentzen, Louis Constine, Joseph O. Deasy … (2010)
            Advances in dose-volume/outcome (or normal tissue complication probability, NTCP) modeling since the seminal Emami paper from 1991 are reviewed. There has been some progress with an increasing number of studies on large patient samples with three-dimensional dosimetry. Nevertheless, NTCP models are not ideal. Issues related to the grading of side effects, selection of appropriate statistical methods, testing of internal and external model validity, and quantification of predictive power and statistical uncertainty, all limit the usefulness of much of the published literature. Synthesis (meta-analysis) of data from multiple studies is often impossible because of suboptimal primary analysis, insufficient reporting and variations in the models and predictors analyzed. Clinical limitations to the current knowledge base include the need for more data on the effect of patient-related cofactors, interactions between dose distribution and cytotoxic or molecular targeted agents, and the effect of dose fractions and overall treatment time in relation to nonuniform dose distributions. Research priorities for the next 5-10 years are proposed. Copyright 2010 Elsevier Inc. All rights reserved.
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              Systemic therapy in the management of metastatic or locally recurrent adenoid cystic carcinoma of the salivary glands: a systematic review.

              Krystina Ho, Nicholas E. Sherman, Matthew G Fury … (2011)
              Adenoid cystic carcinomas (ACC) are rare cancers usually arising in the salivary glands. Once metastatic, the natural history can vary; some patients with indolent cancer remain asymptomatic for long periods, whereas others have rapidly progressive disease. Chemotherapy is generally reserved for the palliative treatment of symptomatic locally recurrent or metastatic disease that is not amenable to further surgery or radiation. Prospective trials of chemotherapy in advanced ACC are limited, and the optimum regimen is unclear. The aim of this systematic review is to summarise and rate the quality of trials assessing chemotherapy for treatment of ACC, by use of the European Lung Cancer Working Party scoring system. Endpoints evaluated include tumour response and rates of symptomatic improvement. 34 trials involving 441 patients are included. We give evidence-based recommendations for management of ACC with chemotherapy, along with considerations for the design of future clinical trials in this disease. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cancer Manag Res
                Journal ID (iso-abbrev): Cancer Manag Res
                Journal ID (publisher-id): Cancer Management and Research
                Title: Cancer Management and Research
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-1322
                Publication date Collection: 2018
                Publication date (Electronic): 26 March 2018
                Volume: 10
                Pages: 583-588
                Affiliations
                [1 ]Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg, Germany
                [2 ]Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany
                [3 ]Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
                [4 ]Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
                [5 ]Department of Radiation Oncology, Klinikum Kempten, Kempten, Germany
                [6 ]Department of Radiation Oncology, University Hospital of Zürich, Zürich, Switzerland
                Author notes
                Correspondence: Denise Bernhardt, Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany, Tel +49 6221 5635654, Fax +49 6221 56565353, Email denise.bernhardt@ 123456med.uni-heidelberg.de
                Article
                Publisher ID: cmar-10-583
                DOI: 10.2147/CMAR.S148395
                PMC ID: 5875408
                PubMed ID: 29618938
                SO-VID: 86b3d6d5-202d-4703-9826-b0ba6b2614be
                Copyright © © 2018 Bernhardt et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Subject: Case Series

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: acc of bartholin’s gland,adenoid cystic carcinoma,acc of the prostate,ion therapy,imrt,tomotherapy,particle irradiation,carbon ion
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: acc of bartholin’s gland, adenoid cystic carcinoma, acc of the prostate, ion therapy, imrt, tomotherapy, particle irradiation, carbon ion

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