Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2011

Open Access 01-12-2011 | Research

Raster-scanned carbon ion therapy for malignant salivary gland tumors: acute toxicity and initial treatment response

Authors: Alexandra D Jensen, Anna V Nikoghosyan, Swantje Ecker, Malte Ellerbrock, Jürgen Debus, Klaus K Herfarth, Marc W Münter

Published in: Radiation Oncology | Issue 1/2011

Login to get access

Abstract

Background and purpose

To investigate toxicity and efficacy in high-risk malignant salivary gland tumors (MSGT) of the head and neck. Local control in R2-resected adenoid cystic carcinoma was already improved with a combination of IMRT and carbon ion boost at only mild side-effects, hence this treatment was also offered to patients with MSGT and microscopic residual disease (R1) or perineural spread (Pn+).

Methods

From November 2009, all patients with MSGT treated with carbon ion therapy were evaluated. Acute side effects were scored according to CTCAE v.4.03. Tumor response was assessed according to RECIST where applicable.

Results

103 patients were treated from 11/2009 to 03/2011, median follow-up is 6 months. 60 pts received treatment following R2 resections or as definitive radiation, 43 patients received adjuvant radiation for R1 and/or Pn+. 16 patients received carbon ion treatment for re-irradiation. Median total dose was 73.2 GyE (23.9 GyE carbon ions + 49,9 Gy IMRT) for primary treatment and 44.9 GyE carbon ions for re-irradiation. All treatments were completed as planned and generally well tolerated with no > CTC°III toxicity. Rates of CTC°III toxicity (mucositis and dysphagia) were 8.7% with side-effects almost completely resolved at first follow-up.
47 patients showed good treatment responses (CR/PR) according to RECIST.

Conclusion

Acute toxicity remains low in IMRT with carbon ion boost also in R1-resected patients and patients undergoing re-irradiation. R2-resected patients showed high rates of treatment response, though follow-up is too short to assess long-term disease control.
Appendix
Available only for authorised users
Literature
1.
Spiro RH: Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg 1986,8(3):177-84.CrossRefPubMed
2.
Chen AM, Granchi PJ, Garcia J, Bucci MK, Fu KK, Eisele DW: Local-regional recurrence after surgery without postoperative irradiation for carciomas of the major salivary glands: implications for adjuvant therapy. Int J Radiat Oncol Biol Phys 2007, 67: 982-987.CrossRefPubMed
3.
Gurney TA, Eisele DW, Weinberg V, Shin E, Lee N: Adenoid cystic carcinoma of the major salivary glands treated with surgery and radiation. Laryngoscope 2005,115(7):1278-82.CrossRefPubMed
4.
Mendenhall WM, Morris CG, Amdur RJ, Werning JW, Hinerman RW, Villaret DB: Radiotherapy alone or combined with surgery for adenoid cystic carcinoma of the head and neck. Head Neck 2004,26(2):154-62.CrossRefPubMed
5.
Chen AM, Bucci MK, Weinberg V, Garcia J, Quivey JM, Schechter NR, Phillips TL, Fu KK, Eisele DW: Adenoid cystic carcinoma of the head and neck treated by surgery with or without postoperative radiation therapy: prognostic features of recurrence. Int J Radiat Oncol Biol Phys 2006,66(1):152-9.CrossRefPubMed
6.
Garden AS, Weber RS, Ang KK, Morrison WH, Matre J, Peters LJ: Postoperative radiation therapy for malignant tumors of minor salivary glands. Outcome and patterns of failure. Cancer 1994,73(10):2563-9.CrossRefPubMed
7.
Terhaard CHJ, Lubsen H, Van der Tweel I, Hilgers FJM, Eijkenboom WMH, Marres HAM, Tjho-Heslinga RE, de Jong JM, Roodenburg JL, Dutch Head and Neck Oncology Cooperative Group: Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head Neck 2004, 26: 681-92. discussion 692-3CrossRefPubMed
8.
Terhaard CHJ, Lubsen H, Rasch CRN, Levendag PC, Kaanders HHAM, Tjho-Heslinga RE, van Den Ende PL, Burlage F, Dutch Head and Neck Oncology Cooperative Group: The role of radiotherapy in the treatment of malignant salivary gland tumors. Int J Radiat Oncol Biol Phys 2005, 61: 103-111.CrossRefPubMed
9.
Schulz-Ertner D, Nikoghosyan A, Didinger B, Munter M, Jakel O, Karger CP, Debus J: Therapy strategies for locally advanced adenoid cystic carcinomas using modern radiation therapy techniques. Cancer 2005,104(2):338-44.CrossRefPubMed
10.
Douglas JG, Koh WJ, Austin-Seymour M, Laramore GE: Treatment of salivary gland neoplasms with fast neutron radiotherapy. Arch Otolaryngol Head Neck Surg 2003,129(9):944-8.CrossRefPubMed
11.
Mizoe JE, Tsujii H, Kamada T, Matuoka Y, Tsuji H, Osaka Y, Hasegawa A, Yamamoto N, Ebihara S, Konno A, Organizing Committee for the Working Group for Head-And-Neck Cancer: Dose escalation study of carbon ion radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004,60(2):358-64.CrossRefPubMed
12.
Huber PE, Debus J, Latz D, Zierhut D, Bischof M, Wannenmacher M, Engenhart-Cabillic R: Radiotherapy for advanced adenoid cystic carcinoma: neutrons, photons or mixed beam? Radiother Oncol 2001,59(2):161-7.CrossRefPubMed
13.
Münter MW, Schulz-Ertner D, Hof H, Nikoghosyan A, Jensen A, Nill S, Huber P, Debus J: Inverse planned stereotactic intensity modulated radiotherapy (IMRT) in the treatment of incompletely and completely resected adenoid cystic carcinomas of the head and neck: initial clinical results and toxicity of treatment. Radiat Oncol 2006, 1: 17.PubMedCentralCrossRefPubMed
14.
Pommier P, Liebsch NJ, Deschler DG, Lin DT, McIntyre JF, Barker FG, Adams J, Am Lopes VV, Varvares M, Loeffler JS, Chan AW: Proton beam radiation therapy for skull base adenoid cystic carcinoma. Arch Otolaryngol Head Neck Surg 2006,132(11):1242-9.CrossRefPubMed
15.
Schulz-Ertner D, Nikoghosyan A, Jäkel O, Haberer T, Kraft G, Scholz M, Wannenmacher M, Debus J: Feasibility and toxicity of combined photon and carbon ion radiotherapy for locally advanced adenoid cystic carcinomas. Int J Radiat Oncol Biol Phys 2003, 56: 391-398.CrossRefPubMed
16.
Münter M, Umathum V, Jensen AD, Nikoghosyan A, Hof H, Jaekel O, Debus J: Combination of intensity modulated radiation therapy (IMRT) and a heavy ion (C12) boost for subtotal resected or inoperable adenoid cystic carcinomas (ACCs) of the head and neck region. J Clin Oncol 2010, 28: e16010.
17.
Jensen AD, Nikoghosyan A, Windemuth-Kieselbach C, Debus J, Münter MW: Combined treatment of malignant salivary gland tumours with intensity-modulated radiation therapy (IMRT) and carbon ions: COSMIC. BMC Cancer 2010, 10: 546.PubMedCentralCrossRefPubMed
18.
Haberer T, Becher W, Schardt D, Kraft G: Magnetic scanning system for heavy ion therapy. Nucl Instr Meth Phys Res 1993, 330: 296-305.CrossRef
19.
Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RA, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 2000, 92: 205-216.CrossRefPubMed
20.
De Crevoisier R, Bourhis J, Domenge C, Wibault P, Koscielny S, Lusinchi A, Mamelle G, Janot F, Julieron M, Leridant AM, Marandas P, Armand JP, Schwaab G, Luboinski B, Eschwege F: Full-dose reirradiation for unresectable head and neck carcinoma: experience at the Gustave-Roussy Institute in a series of 169 patients. J Clin Oncol 1998, 16: 3556-3562.PubMed
21.
Roh KW, Jang JJ, Kim MS, Sun DI, Kim BS, Jung SL, Kang JH, Yoo SC, Jang HS, Chung SM, Kim YS: Fractionated stereotactic radiotherapy as reirradiation for locally recurrent head and neck cancer. Int J Radiat Oncol Biol Phys 2009, 74: 1348-1355.CrossRefPubMed
22.
Lee N, Chan K, Bekelman JE, Zhung J, Mechalakos J, Narayana A, Wolden S, Venkatraman ES, Pfister D, Kraus D, Shah J, Zelefsky MJ: Salvage re-irradiation for recurrent head and neck cancer. Int J Radiat Oncol Biol Phys 2007, 68: 731-740.CrossRefPubMed
23.
Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK, Raben D, Baselga J, Spencer SA, Zhu J, Youssoufian H, Rowinsky EK, Ang KK: Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 2010, 11: 21-28.CrossRefPubMed
24.
Pignon JP, le Maitre A, Maillard E, Bourhis J, MACH-NC Collaborative Group: Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update. Int J Radiat Oncol Biol Phys 2007, 69: 112-114.CrossRef
25.
Haddad RI, Posner MR, Busse PM, Norris CM, Goguen LA, Wirth LJ, Blinder R, Krane JF, Tishler RB: Chemoradiotherapy for adenoid cystic carcinoma: preliminary results of an organ sparing approach. Am J Clin Oncol 2006, 29: 153-157.CrossRefPubMed
26.
Tanvetyanon T, Qin D, Padhya T, McCaffrey J, Zhu W, Boulware D, DeConti R, Trotti A: Outcomes of postoperative concurrent chemoradiotherapy for locally advanced major salivary gland carcinoma. Arch Otolaryngol Head Neck Surg 2009, 135: 687-692.CrossRefPubMed
27.
Pederson A, Haraf D, Blair EA, Stenson KM, Witt ME, Vokes EE, Salama JK: Chemoreirradiation for recurrent salivary gland malignancies. Radiother Oncol 2010, 95: 308-311.CrossRefPubMed
28.
Jensen AD, Krauss J, Weichert W, Debus J, Münter MW: RadioImmunotherapy for adenoid cystic carcinoma: a single-institution series of combined treatment with cetuximab. Radiother Oncol 2010, 5: 102.CrossRef
29.
Jensen AD, Nikoghosyan AV, Hinke A, Debus J, Münter MW: Combined treatment of adenoid cystic carcinoma with cetuximab and IMRT plus C12 heavy ion boost: ACCEPT [ACC, Erbitux ® and particle therapy]. BMC Cancer 2011, 11: 70.PubMedCentralCrossRefPubMed
Metadata
Title
Raster-scanned carbon ion therapy for malignant salivary gland tumors: acute toxicity and initial treatment response
Authors
Alexandra D Jensen
Anna V Nikoghosyan
Swantje Ecker
Malte Ellerbrock
Jürgen Debus
Klaus K Herfarth
Marc W Münter
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-6-149

Other articles of this Issue 1/2011

Radiation Oncology 1/2011 Go to the issue

Research

Stereotactic body radiation therapy for melanoma and renal cell carcinoma: impact of single fraction equivalent dose on local control

Research

Increased betulinic acid induced cytotoxicity and radiosensitivity in glioma cells under hypoxic conditions

Research

Toxicity after radiochemotherapy for glioblastoma using temozolomide - a retrospective evaluation

Research

Carbon ion therapy for advanced sinonasal malignancies: feasibility and acute toxicity

Research

Concurrent image-guided intensity modulated radiotherapy and chemotherapy following neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma

Research

Effect of neoadjuvant chemoradiation and postoperative radiotherapy on expression of heat shock protein 70 (HSP70) in head and neck vessels