1Department of Radiation Oncology,Shanghai Proton and Heavy Ion Center,Shanghai 201315,China; 2Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201315,China; 3Department of Radiation Oncology,Fudan University Cancer Hospital,Shanghai 200032,China
Abstract:Objective To observe the short-term effect and toxicities after carbon ion radiotherapy (CIRT) for tracheal adenoid cystic carcinoma (TACC). Methods From March 2016 to October 2017,a total of 10 patients with TACC were treated using CIRT.Among them,three patients had recurrent disease (two after surgery,and one after brachytherapy),one received bronchoscopic cryosurgery for stage Ⅰ disease,and the other 9 had locally advanced disease (3/6 received endoscopic treatment before CIRT).All patients received CIRT using pencil-beam scanning technique. Except that the patient with recurrent disease after brachytherapy received 60 GyE/20 Fx,the patient received cryosurgery and one recurrent patient after surgery received 66 GyE/22 Fx,all other patients received 69 GyE/23 Fx. Results The median follow-up time was 5.5(1.5-16.4) months. Among the 9 patients with gross tumors,3 patients achieved complete response,2 achieved partial response,and 4 remained stable disease per RECIST 1.1 criteria. The post-cryosurgery patient remained no evidence of disease. Except 1 patient experienced grade 4 tracheal stenosis,no other grade ≥3 adverse effects were observed. Grade 2 acute toxicities included 1 hoarseness and 1 neutropenia,both relieved after CIRT.Hypothyroidism in one patient was the only observed grade 2 late toxicity. Conclusion CIRT is safe and effective in the management of TACC during a short-time observation.
Chen Jian,Mao Jingfang,Ma Ningyi et al. Preliminary Observation of Carbon Ion Radiotherapy for Tracheal Adenoid Cystic Carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(3): 168-172.
[1] Urdaneta AI,Yu JB,Wilson LD.Population based cancer registry analysis of primary tracheal carcinoma[J].Am J Clin Oncol,2011,34(1):32-37.DOI:10.1097/COC.0b013e3181cae8ab. [2] Gaissert HA,Mark EJ.Tracheobronchial gland tumors[J].Moff Cancer Center,2006,13(4):286-294.DOI:10.1177/107327480601300406. [3] Grillo HC,Mathisen DJ.Primary tracheal tumors:treatment and results[J].Ann Thorac Surg,1990,49(1):69-77. [4] Kanematsu T,Yohena T,Uehara T,et al. Treatment outcome of resected and nonresected primary adenoid cystic carcinoma of the lung[J].Ann Thorac Cardiovascul Surg,2002,8(2):74-77. [5] Molina JR,Aubry MC,Lewis JE,et al. Primary salivary gland-type lung cancer:spectrum of clinical presentation,histopathologic and prognostic factors[J].Cancer,2007,110(10):2253-2259.DOI:10.1002/cncr.23048. [6] Bhattacharyya N.Contemporary staging and prognosis for primary tracheal malignancies:a population-based analysis[J].Otolaryngol Head Neck Surg,2004,131(5):639-642.DOI:10.1016/j.otohns.2004.05.018. [7] Freitag L,Ernst A,Unger M,et al. A proposed classification system of central airway stenosis[J].Euro Respirat J,2007,30(1):7-12.DOI:10.1183/09031936.00132804. [8] Shadmehr MB,Farzanegan R,Graili P,et al. Primary major airway tumors;management and results[J].Cardio-Thorac Surg,2011,39(5):754.DOI:10.1016/j.ejcts.2010.08.047. [9] Park CM,Goo JM,Lee HJ,et al. Tumors in the tracheobronchial tree:CT and FDG PET features[J].Radiographics,2009,29(1):71.DOI:10.1148/rg.291085126. [10] Chen F,Huang M,Xu Y et al. Primary tracheal adenoid cystic carcinoma:adjuvant treatment outcome[J].Int J Clin Oncol,2015,20(4):686-692.DOI:10.1007/s10147-014-0771-6. [11] Gaissert HA,Grillo HC,Shadmehr MB,et al. Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina[J].Ann Thorac Surg,2004,78(6):1889-1897.DOI:10.1016/j.athoracsur.2004.05.064. [12] Yang H,Yao F,Tantai J,et al. Resected tracheal adenoid cystic carcinoma:improvements in outcome at a single institution[J].Ann Thorac Surg,2016,101(1):294-300.DOI:10.1016/j.athoracsur.2015.06.073. [13] Takagi M,Ddemizu Y,Hashimoto N,et al. Treatment outcomes of particle radiotherapy using protons or carbon ions as a single-modality therapy for adenoid cystic carcinoma of the head and neck[J].Radiother Oncol,2014,113(3):364-370.DOI:10.1016/j.radonc.2014.11.031. [14] 高晶,孔琳,管西寅,等.质子碳离子治疗腺样囊性癌的近期疗效及不良反应[J].中华放射医学与防护杂志,2016,36(8):607-610.DOI:10.3760/cma.j.issn.0254-5098.2016.08.010. Gao J,Kong L,Guan XY,et al. Short-term efficacy and adverse reactions of proton carbon ion in the treatment of adenoid cystic[J].Chin J Radiol Med Protect,2016,36(8):607-610.DOI:10.3760/cma.j.issn.0254-5098.2016.08.010. [15] Jensen AD,Nikoghosyan AV,Poulakis M,et al. Combined intensity-modulated radiotherapy plus raster-scanned carbon ion boost for advanced adenoid cystic carcinoma of the head and neck results in superior locoregional control and overall survival[J].Cancer,2015,121(17):3001-3009.DOI:10.1002/cncr.29443. [16] Bittner N,Koh WJ,Laramore GE,et al. Treatment of locally advanced adenoid cystic carcinoma of the trachea with neutron radiotherapy[J].Radiat Oncol Biol,2008,72(2):410-414.DOI:10.1016/j.ijrobp.2008.01.016. [17] Zhao Y,Zhao H,Fan L,et al. Adenoid cystic carcinoma in the bronchus behaves more aggressively than its tracheal counterpart[J].Ann Thorac Surg,2013,96(6):1998-2004.DOI:10.1016/j.athoracsur.2013.08.009. [18] 王永岗,张汝刚,张宏图,等.气管、支气管腺样囊性癌[J].中华胸心血管外科杂志,2000,16(6):357-358. Wang YG,Zhang RG,Zhang HT,et al. Adenoid cystic carcinoma of trachea and bronchi[J].Chin J Thorac Cardiovascul,2000,16(6):357-358. [19] Fields JN,Rigaud G,Emami BN.Primary tumors of the trachea. Results of radiation therapy[J].Cancer,1989,63(12):2429-2433. [20] Mornex F,Coquard R,Danhier S,et al. Role of radiation therapy in the treatment of primary tracheal carcinoma[J].Radiat Oncol Biol,1998,41(2):299-305. [21] 秦明,傅瑜,于大平,等.气管、支气管腺样囊性癌的诊断与治疗[J].中国肺癌杂志,2010,13(6):628-631.DOI:10.3779/j.issn.1009-3419.2010.06.016. Qin M,Fu Y,Yu DP,et al. Diagnosis and treatment of adenoid cystic carcinoma of trachea and bronchus[J].Chin J Lung Cancer,2010,13(6):628-631.DOI:10.3779/j.issn.1009-3419.2010.06.016.