Oncotarget

Clinical Research Papers:

Clinical significance of post-surgical residual tumor burden and radiation therapy in treating patients with lacrimal adenoid cystic carcinoma

Jae Myoung Noh, Eonju Lee, Yong Chan Ahn _, Dongryul Oh, Yoon-Duck Kim, Kyung In Woo, Young-Hyeh Ko and Seokhwi Kim

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Oncotarget. 2016; 7:60639-60646. https://doi.org/10.18632/oncotarget.10259

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Abstract

Jae Myoung Noh1,*, Eonju Lee1,4,*, Yong Chan Ahn1, Dongryul Oh1, Yoon-Duck Kim2, Kyung In Woo2, Young-Hyeh Ko3 and Seokhwi Kim3

1 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

2 Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

3 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

4 Department of Radiation Oncology, Samsung Changwon Hospital, Changwon, Republic of Korea

* These authors have contributed equally to this work

Correspondence to:

Yong Chan Ahn, email:

Keywords: adenoid cystic carcinoma, lacrimal gland, surgery, radiation therapy

Received: February 24, 2016 Accepted: June 13, 2016 Published: June 23, 2016

Abstract

Retrospective analyses were done on 19 lacrimal adenoid cystic carcinoma (ACC) patients who underwent curative treatment between 1997 and 2013. Nine patients (47.4%) had T1-2 disease and ten (52.6%) had T4 disease. Surgical procedures were globe-preserving tumor resection in 11 patients (57.9%), incisional biopsy in five (26.3%), and orbital exenteration was undertaken in three (15.8%). Residual tumor burdens were R0/1 in 12 patients (63.2%) and R2 in seven (36.8%). Radiation therapy (RT) was recommended to all patients, and 16 (84.2%) completed RT (median 60 Gy). After median follow-up of 57.5 months, seven (36.8%) developed progression and three (15.8%) died. Local recurrence occurred in four patients (21.1%), distant metastasis in one (5.3%), and combined local recurrence and distant metastasis in two (10.5%). Progression-free survival and overall survival rates at 5-years were 64.5% and 82.6%, respectively. Among 12 patients following R0/1 resection, two (16.7%) developed local recurrence and none died, while among seven following R2 resection, five (71.4%) developed progression and three (42.9%) died. RT following R0/R1 resection could reduce progression. Globe-preserving surgery and RT seemed optimal strategy for T1-2 disease. Careful attention should to be paid to minimize residual tumor burden at surgery and effort for safe radiation dose escalation would be desired.


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