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Role of postoperative radiotherapy in resected adenoid cystic carcinoma of the head and neck

 Seo Hee Choi  ;  Andrew Jihoon Yang  ;  Sun Och Yoon  ;  Hye Ryun Kim  ;  Min Hee Hong  ;  Se-Heon Kim  ;  Eun Chang Choi  ;  Ki Chang Keum  ;  Chang Geol Lee 
 RADIATION ONCOLOGY, Vol.17(1) : 197, 2022-12 
Journal Title
Issue Date
Carcinoma* ; Carcinoma, Adenoid Cystic* / radiotherapy ; Carcinoma, Adenoid Cystic* / surgery ; Head ; Humans ; Margins of Excision ; Neck ; Retrospective Studies
Adenoid cystic carcinoma ; Local recurrence ; Postoperative radiotherapy ; Prognosis ; Radiation
Purpose: Although postoperative radiotherapy (PORT) is demonstrably effective in local control of head and neck adenoid cystic carcinoma (HNACC), its application is controversial and the subset of patients who would benefit most from PORT is unknown. Herein, we analyzed the data of HNACC patients to clarify the role of PORT.

Methods: We retrospectively reviewed 187 patients with nonmetastatic HNACC who underwent surgical resection between 2005 and 2019. The study endpoints were locoregional failure-free survival (LRFFS), progression-free survival (PFS), and overall survival (OS). Subgroup analysis and recursive partitioning analysis (RPA) were performed to identify patients most likely to benefit from PORT.

Results: With a median follow-up of 84.7 months, the 5-year LRFFS, PFS, and OS were 70.0%, 52.6%, and 86.4%, respectively. Survival was significantly shorter in patients who experienced local failure than in those who did not (5-year OS: 88.1% vs. 80.5%, P = 0.001). The local failure rate was significantly lower in patients who underwent PORT (16.9% vs. 31.0%, P = 0.021), despite the high frequency of adverse factors. Especially, significant decreases in local failure and similar OS rates could be obtained after PORT among patients with positive margins, T2-4 stage disease, and minor salivary gland tumors. The RPA model for PFS categorized patients into four groups according to three prognostic factors (T-stage, location, and sex). The RPA model for LRFFS and OS suggested three groups based on two factors (T-stage, margin for LRFFS; T-stage, grade 3 for OS).

Conclusion: PORT could prevent dismal survival, while significantly reducing local failures in high-risk HNACC patients.
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6. Others (기타) > Others (기타) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo
Kim, Se Heon(김세헌)
Kim, Hye Ryun(김혜련) ORCID logo
Yang, Andrew Jihoon(양지훈) ORCID logo
Yoon, Sun Och(윤선옥) ORCID logo
Lee, Chang Geol(이창걸) ORCID logo
Choi, Seo Hee(최서희) ORCID logo
Choi, Eun Chang(최은창)
Hong, Min Hee(홍민희) ORCID logo
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