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- Title
Proton therapy for skull-base adenoid cystic carcinomas: A case series and review of literature.
- Authors
Nangia, Sapna; Gaikwad, Utpal; Noufal, M P; Chilukuri, Srinivas; Patro, Kartikeswar; Nakra, Vineet; Panda, Pankaj Kumar; Mathew, Ashwathy Susan; Sharma, Dayananda S; Jalali, Rakesh
- Abstract
<bold>Purpose: </bold>An indolent nature, with a high risk of local recurrence along with the potential for distant metastases, makes the relatively rare adenoid cystic carcinomas (ACCs) of the head-and-neck region, a unique entity. In the base of skull (BOS) region, these cancers require radiation doses as high as 70-72 GyE in proximity to critical structures. Proton therapy (PT) confers physical and radiobiological advantages and local control at 2-5 years exceeding 80% in most series, compared with below 60% with photon-based techniques. We report a case series of ACCs of the BOS, treated with image-guided, intensity-modulated PT (IMPT).<bold>Materials and Methods: </bold>During 2019-2020, we treated six patients with skull-base ACC IMPT with on-board, cross-sectional image guidance. Dosimetric data, toxicity, and early outcomes were studied, and a comparative review of literature was done.<bold>Results: </bold>Three patients underwent PT/proton-photon treatment for residual/inoperable lesions and three patients underwent reirradiation for recurrent lesions. The prescription was 70 GyE in 31-35 fractions, and 95% of the clinical target volume (CTV) received 98% of the prescribed dose in five of the six patients. Grade 3 mucositis and skin reactions were noted in two patients and one patient, respectively. Five of the six patients were controlled locally at a median follow-up of 15 months.<bold>Conclusion: </bold>The radiobiological and physical characteristics of PT help to deliver high doses with excellent CTV coverage in skull-base ACCs, adjacent to critical neurological structures.
- Publication
Journal of Cancer Research & Therapeutics, 2022, Vol 18, Issue 2, p629
- ISSN
0973-1482
- Publication type
journal article
- DOI
10.4103/jcrt.jcrt_1236_21