Adding concurrent chemotherapy to postoperative radiotherapy improves locoregional control but Not overall survival in patients with salivary gland adenoid cystic carcinoma—a propensity score matched studyReport as inadecuate




Adding concurrent chemotherapy to postoperative radiotherapy improves locoregional control but Not overall survival in patients with salivary gland adenoid cystic carcinoma—a propensity score matched study - Download this document for free, or read online. Document in PDF available to download.

Radiation Oncology

, 11:47

Clinical Radiation Oncology

Abstract

PurposeTo compare the long-term outcomes in patients with salivary gland adenoid cystic carcinoma SGACC treated with post-operative chemoradiotherapy POCRT versus post-operative radiotherapy PORT.

MethodsWe retrospectively reviewed the records of 91 SGACC patients treated with surgery followed by PORT n = 58 or POCRT n = 33 between 2000 and 2013. Treatment outcomes between groups were compared using propensity score matching 1:1 nearest neighbor.

ResultsThe median radiation dose was 66 Gy, and patients were followed up for a median of 71 months. Cisplatin-based concurrent regimens were the most commonly used chemotherapy schedules. In the entire study cohort, patients undergoing POCRT showed a trend toward higher locoregional control LRC rates than those treated with PORT alone at both 5 and 8 years 97 and 97 % versus 84 and 79 %, respectively; P = .066. Distant metastases were the most common form of treatment failure and occurred in 31 34 % patients PORT, n = 17; POCRT, n = 14. After propensity score matching 33 pairs, patients receiving POCRT had 5- and 8 year LRC rates of 97 and 97 %, respectively, compared with 79 and 67 % for patients treated with PORT alone P = .017. The two groups did not differ significantly in terms of distant metastasis-free survival DMFS, disease-free survival DFS, and overall survival OS. However, a significantly better opioid-requiring pain-free survival ORPFS was achieved in POCRT group P = .038. Subgroup analyses revealed that patients with stage III − IV disease P = .040 and .017, positive surgical margins P = .011 and .050, or perineural invasion P = .013 and .035 had significantly higher 5- and 8 year LRC and ORPFS when treated with POCRT, respectively.

ConclusionsIn SGACC patients, adding concurrent chemotherapy to PORT may increase LRC and ORPFS rates, particularly in presence of stage III − IV disease, positive surgical margins, or perineural invasion. However, no significant differences in DMFS, DFS, and OS were observed.

KeywordsSalivary gland cancer Chemoradiotherapy Adenoid cystic carcinoma Postoperative radiotherapy Propensity score Head and neck  Download fulltext PDF



Author: Cheng-En Hsieh - Chien-Yu Lin - Li-Yu Lee - Lan-Yan Yang - Chun-Chieh Wang - Hung-Ming Wang - Joseph Tung-Chieh Chang - Ka

Source: https://link.springer.com/







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