Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristics
2.2. Compliance
2.3. Response and Survival
2.4. Toxicities
3. Discussion
4. Materials and Methods
4.1. Ethics Statement
4.2. Patients and Study Design
4.3. PBT
4.4. IAIC
4.5. Patient Assessments (Follow-up)
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristic | n or Median (% or Range) |
---|---|
Number of patients | 15 |
Age, years | 60 (31–78) |
Sex | |
Male | 5 (33) |
Female | 10 (67) |
ECOG-PS | |
0 | 10 (67) |
1 | 5 (33) |
T classification * | |
T3 | 1 (7) |
T4a | 12 (80) |
T4b | 2 (13) |
N classification * | |
N0 | 9 (60) |
N1 | 2 (13) |
N2b | 2 (13) |
N2c | 2 (13) |
M classification * | |
M0 | 10 (67) |
M1 | 5 (33) |
Stage | |
IVA | 9 (60) |
IVB | 1(7) |
IVC | 5 (33) |
Location | |
Right | 9 (60) |
Left | 6 (40) |
FDG accumulation before treatment | 7.3 (1–12.5) |
Reasons for not performing surgery | |
Operabl | |
Refusal | 6 (40) |
Old age | 1 (7) |
Inoperable | |
Locally advanced | 3 (20) |
Distant metastasis | 2 (13) |
Locally advanced + distant metastasis | 3 (20) |
Characteristics | n or Median (% or Range) |
---|---|
GTV | 50 (21–120) mL |
PTV | 160 (75–331) mL |
Prescribed dose | |
61.6 Gy (RBE)/28 fr. | 1 (7) |
66.0 Gy (RBE)/30 fr. | 4 (26) |
70.4 Gy (RBE)/32 fr. | 4 (26) |
72.6 Gy (RBE)/33 fr. | 1 (7) |
others | 5 (33) |
Total radiation dose | |
BED10 | 84.4 (75.2–88.6) Gy (RBE) |
BED3 | 119.1 (106.8–125.8) Gy (RBE) |
EQD10/2 | 70.3 (62.6–73.8) Gy (RBE) |
EQD3/2 | 71.5 (64.1–75.5) Gy (RBE) |
Total dose of cisplatin on IAIC | 410 (200–580) mg |
Arterial injection vessels | |
LA + ECA | 6 (40) |
LA | 1 (7) |
ECA | 8 (53) |
Nutrition | |
PEG | 6 (40) |
Oral intake | 5 (33) |
Naso-gastric tube | 4 (26) |
Factors | No. of Patients | p Value | |
---|---|---|---|
OS | LC | ||
Age | 0.790 | 0.264 | |
<60 years | 7 | ||
≥60 years | 8 | ||
Sex | 0.430 | 0.724 | |
Male | 5 | ||
Female | 10 | ||
Surgical indication | 0.720 | 0.264 | |
Operable | 7 | ||
Inoperable | 8 | ||
Primary tumor size (GTV) | 0.744 | 0.264 | |
<50 mL | 7 | ||
≥50 mL | 8 | ||
Irradiation volume (PTV) | 0.835 | 0.264 | |
<160 mL | 7 | ||
≥160 mL | 8 | ||
Lymph node status | 0.157 | 0.264 | |
Negative | 9 | ||
Positive | 6 | ||
Lung metastasis before treatment | 0.007 * | 0.061 | |
Negative | 10 | ||
Positive | 5 | ||
SUVmax value on PET | 0.284 | 0.371 | |
<7.3 | 8 | ||
≥7.3 | 7 | ||
Reduction of SUVmax after treatment | 0.364 | 0.371 | |
<5.9 | 7 | ||
≥5.9 | 8 | ||
Total dose; EQD10/2 (GyE10/2) | 0.664 | 0.371 | |
<70.3 Gy (RBE) | 8 | ||
≥70.3 Gy (RBE) | 7 | ||
Total dose of cisplatin on IAIC | 0.607 | 0.264 | |
<410 mg | 7 | ||
≥410 mg | 8 |
Toxicity, maximum/latest | Grade, n | ||||
---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | |
Mucositis oral | 0/2 | 3/0 | 12/0 | 0 | 0 |
Dermatitis radiation | 4/0 | 6/0 | 3/0 | 0 | 0 |
Neutropenia | 0 | 6/0 | 2/0 | 0 | 0 |
Anemia | 0 | 2/0 | 1/0 | 0 | 0 |
Platelet count decreased | 0 | 1/0 | 0 | 0 | 0 |
Nausea | 6/0 | 4/0 | 0 | - | - |
Acute kidney injury | 0 | 0 | 0 | 0 | 0 |
Hepatobiliary disorders | 1/0 | 0 | 0 | 0 | 0 |
Dry mouth | 7/3 | 2/0 | 0 | - | - |
Dysgeusia | 9/4 | 6/0 | - | - | - |
Laryngeal edema | 3/0 | 0 | 0 | 0 | 0 |
Dysarthria | 3/1 | 2/1 | 0 | - | - |
Dysphagia | 4/2 | 2/1 | 2/0 | 1/1 | 0 |
Pharyngeal mucositis or ulcer | 10/4 | 3/0 | 2/0 | 0 | 0 |
Pharyngeal necrosis | - | - | 0 | 0 | 1/1 |
Osteonecrosis of jaw | 0 | 1/0 | 0 | 0 | 0 |
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Takayama, K.; Kato, T.; Nakamura, T.; Azami, Y.; Ono, T.; Suzuki, M.; Takada, A.; Yamaguchi, H.; Seto, I.; Nakasato, T.; et al. Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue. Cancers 2019, 11, 1413. https://doi.org/10.3390/cancers11101413
Takayama K, Kato T, Nakamura T, Azami Y, Ono T, Suzuki M, Takada A, Yamaguchi H, Seto I, Nakasato T, et al. Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue. Cancers. 2019; 11(10):1413. https://doi.org/10.3390/cancers11101413
Chicago/Turabian StyleTakayama, Kanako, Takahiro Kato, Tatsuya Nakamura, Yusuke Azami, Takashi Ono, Motohisa Suzuki, Akinori Takada, Hisashi Yamaguchi, Ichiro Seto, Tatsuhiko Nakasato, and et al. 2019. "Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue" Cancers 11, no. 10: 1413. https://doi.org/10.3390/cancers11101413
APA StyleTakayama, K., Kato, T., Nakamura, T., Azami, Y., Ono, T., Suzuki, M., Takada, A., Yamaguchi, H., Seto, I., Nakasato, T., Wada, H., Kikuchi, Y., Mitsudo, K., Fuwa, N., & Murakami, M. (2019). Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue. Cancers, 11(10), 1413. https://doi.org/10.3390/cancers11101413