Intensity modulated radiation therapy may improve survival for tracheal-bronchial adenoid cystic carcinoma: A retrospective study of 133 cases.

Abstract

PURPOSES:

This study aimed to evaluate the role of radiotherapy (RT) and intensity modulated radiation therapy (IMRT) in adjuvant and definitive settings of tracheal-bronchial adenoid cystic carcinoma (TACC) treatment.

MATERIALS/METHODS:

TACC patients (n = 133) treated with surgery and/or RT curatively in our institution between January 1st, 1984 and December 31st, 2017 were analyzed retrospectively.

RESULTS:

Among the 116 patients undergoing surgery, 50 (43.1 %) achieved complete resections and 66 (56.9 %) had positive surgical margins. For patients with positive margins, overall adjuvant RT was correlated with no significantly improved OS (10-year: 58.0 % vs. 47.9 %; P =  0.340) and a slight LRFS benefit (5-year: 81.9 % vs.75.6 %; P =  0.056), but adjuvant IMRT showed significant superiority in both OS (10-year: 82.9 % vs. 47.9 %; P =  0.031) and LRFS (5-year: 100.0 % vs. 75.6 %; P =  0.001) in comparison with no postoperative RT. Multivariate analysis also identified adjuvant IMRT as a significant favorable factor with OS (HR = 0.186, 95 %CI: 0.039-0.883; P =  0.034). For 17 patients receiving definitive RT, IMRT achieved promising 5-year OS of 88.9 % and LRFS of 64.3 %, yet no significant difference from non-IMRT group was reached (P = 0.447 and 0.706). Different therapies presented no significantly different impact on DMFS, whilst DMFS explained more of the OS variances (P < 0.001, R2 = 0.480) than LRFS (P < 0.001, R2 = 0.323).

CONCLUSION:

IMRT could confer greatly improved OS and LRFS in postoperative setting for TACC patients with positive surgical margins. IMRT was also a good therapeutic option for definitive TACC with promising survival and local control.

• Authors: Yufan Yang, Juntao Ran, Yalong Wang, Zongmei Zhou, Dongfu Chen, Qinfu Feng, Jun Liang, Zefen Xiao, Zhouguang Hui, Jima Lv, Yibo Gao, Jie He, Nan Bi, Luhua Wang
• Journal: Lung cancer (Amsterdam, Netherlands) (Lung Cancer) Vol. 157 Pg. 116-123 (07 2021) ISSN: 1872-8332 [Electronic] Ireland
• PMID: 34020823 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier B.V. All rights reserved.

Topics

• Carcinoma, Adenoid Cystic (radiotherapy)
• Disease-Free Survival
• Humans
• Lung Neoplasms
• Radiotherapy, Intensity-Modulated
• Retrospective Studies
• Tracheal Neoplasms (radiotherapy)