Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution
Abstract Background Primary adenoid cystic carcinomas (ACCs) of the trachea are rare tumors of the central bronchial system. In patients presenting with unresectable tumors, severe comorbidities, or incomplete surgical resection, definitive radiotherapy is currently the recommended treatment. Irradi...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-019-1323-z |
| _version_ | 1831741358260355072 |
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| author | Benjamin A. Högerle Felix Lasitschka Thomas Muley Nina Bougatf Klaus Herfarth Sebastian Adeberg Martin Eichhorn Jürgen Debus Hauke Winter Stefan Rieken Matthias Uhl |
| author_facet | Benjamin A. Högerle Felix Lasitschka Thomas Muley Nina Bougatf Klaus Herfarth Sebastian Adeberg Martin Eichhorn Jürgen Debus Hauke Winter Stefan Rieken Matthias Uhl |
| author_sort | Benjamin A. Högerle |
| collection | DOAJ |
| description | Abstract Background Primary adenoid cystic carcinomas (ACCs) of the trachea are rare tumors of the central bronchial system. In patients presenting with unresectable tumors, severe comorbidities, or incomplete surgical resection, definitive radiotherapy is currently the recommended treatment. Irradiation with carbon ions (C12) has shown promising local control (LC) and survival rates in cases of ACCs of the head and neck. No data on the therapeutic efficacy of C12 radiotherapy in treating tracheal ACC has been published. Methods All patients with histologically confirmed ACC of the trachea treated with surgery and/or radiation treatment at Heidelberg University Hospital between 1991 and 2017 were included in this analysis. Patient and treatment characteristics, short- and long-term toxicity after radiotherapy, overall survival (OS), freedom from local progression (FFLP), and freedom from distant progression (FFDP) were prospectively acquired and retrospectively analyzed. Results Thirty-eight patients (23 women and 15 men) with a median age of 51 were treated by surgery (n = 20) and/or radiotherapy with either C12 (n = 7) or photons (n = 24). Of these patients, 61% presented with locally advanced (stage 4) ACC. The median follow-up for all patients was 74.5 months. The 5-year OS for all patients was 95% (10-year: 81%). The 5-year FFLP and FFDP were 96% (10-year: 83%) and 69% (10-year: 53%), respectively. In patients who underwent surgery alone, the 5-year OS was 100% (10-year: 80%). The 5-year FFLP and FFDP were 100% (10-year: 100%) and 80% (10-year: 60%), respectively. In patients who underwent radiotherapy alone, the 5-year OS was 100% (10-year: 83%). The 5-year FFLP and FFDP were 88% (10-year: 44%) and 67% (10-year: 34%), respectively. In patients who received multi-modal treatment including surgery and adjuvant radiotherapy, the 5-year OS was 84% (10-year: 84%). The 5-year FFLP was 100% (10-year: 100%) and the 5-year FFDP was 65% (10-year, 65%). Conclusions The long-term prognosis is favorable if surgery is performed. In cases of an incomplete resection, good OS can still be achieved following adjuvant radiotherapy. For radiotherapy, irradiation with C12 shows promising first results. However, more data is needed to prove the long-term advantage of C12 over photons. Trial registration The ethics committee of the Heidelberg University Hospital approved the retrospective data analysis (S-174/2019). |
| first_indexed | 2024-12-21T14:15:15Z |
| format | Article |
| id | doaj.art-05b26e899c3843d6bf3cab4640e5105d |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-21T14:15:15Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-05b26e899c3843d6bf3cab4640e5105d2022-12-21T19:00:56ZengBMCRadiation Oncology1748-717X2019-07-011411910.1186/s13014-019-1323-zPrimary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institutionBenjamin A. Högerle0Felix Lasitschka1Thomas Muley2Nina Bougatf3Klaus Herfarth4Sebastian Adeberg5Martin Eichhorn6Jürgen Debus7Hauke Winter8Stefan Rieken9Matthias Uhl10Department of Thoracic Surgery, Thoraxklinik, Heidelberg University HospitalInstitute of Pathology, Heidelberg University HospitalTranslational Research Unit, Thoraxklinik, Heidelberg University Hospital, Member of the German Center for Lung ResearchDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Thoracic Surgery, Thoraxklinik, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalDepartment of Thoracic Surgery, Thoraxklinik, Heidelberg University HospitalDepartment of Radiation Oncology, Heidelberg University HospitalNational Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO)Abstract Background Primary adenoid cystic carcinomas (ACCs) of the trachea are rare tumors of the central bronchial system. In patients presenting with unresectable tumors, severe comorbidities, or incomplete surgical resection, definitive radiotherapy is currently the recommended treatment. Irradiation with carbon ions (C12) has shown promising local control (LC) and survival rates in cases of ACCs of the head and neck. No data on the therapeutic efficacy of C12 radiotherapy in treating tracheal ACC has been published. Methods All patients with histologically confirmed ACC of the trachea treated with surgery and/or radiation treatment at Heidelberg University Hospital between 1991 and 2017 were included in this analysis. Patient and treatment characteristics, short- and long-term toxicity after radiotherapy, overall survival (OS), freedom from local progression (FFLP), and freedom from distant progression (FFDP) were prospectively acquired and retrospectively analyzed. Results Thirty-eight patients (23 women and 15 men) with a median age of 51 were treated by surgery (n = 20) and/or radiotherapy with either C12 (n = 7) or photons (n = 24). Of these patients, 61% presented with locally advanced (stage 4) ACC. The median follow-up for all patients was 74.5 months. The 5-year OS for all patients was 95% (10-year: 81%). The 5-year FFLP and FFDP were 96% (10-year: 83%) and 69% (10-year: 53%), respectively. In patients who underwent surgery alone, the 5-year OS was 100% (10-year: 80%). The 5-year FFLP and FFDP were 100% (10-year: 100%) and 80% (10-year: 60%), respectively. In patients who underwent radiotherapy alone, the 5-year OS was 100% (10-year: 83%). The 5-year FFLP and FFDP were 88% (10-year: 44%) and 67% (10-year: 34%), respectively. In patients who received multi-modal treatment including surgery and adjuvant radiotherapy, the 5-year OS was 84% (10-year: 84%). The 5-year FFLP was 100% (10-year: 100%) and the 5-year FFDP was 65% (10-year, 65%). Conclusions The long-term prognosis is favorable if surgery is performed. In cases of an incomplete resection, good OS can still be achieved following adjuvant radiotherapy. For radiotherapy, irradiation with C12 shows promising first results. However, more data is needed to prove the long-term advantage of C12 over photons. Trial registration The ethics committee of the Heidelberg University Hospital approved the retrospective data analysis (S-174/2019).http://link.springer.com/article/10.1186/s13014-019-1323-zAdenoid cystic carcinomaCarcinoma of the tracheaCarbon ionRadiation therapyMulti-modal treatmentTracheal tumor surgery |
| spellingShingle | Benjamin A. Högerle Felix Lasitschka Thomas Muley Nina Bougatf Klaus Herfarth Sebastian Adeberg Martin Eichhorn Jürgen Debus Hauke Winter Stefan Rieken Matthias Uhl Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution Radiation Oncology Adenoid cystic carcinoma Carcinoma of the trachea Carbon ion Radiation therapy Multi-modal treatment Tracheal tumor surgery |
| title | Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution |
| title_full | Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution |
| title_fullStr | Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution |
| title_full_unstemmed | Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution |
| title_short | Primary adenoid cystic carcinoma of the trachea: clinical outcome of 38 patients after interdisciplinary treatment in a single institution |
| title_sort | primary adenoid cystic carcinoma of the trachea clinical outcome of 38 patients after interdisciplinary treatment in a single institution |
| topic | Adenoid cystic carcinoma Carcinoma of the trachea Carbon ion Radiation therapy Multi-modal treatment Tracheal tumor surgery |
| url | http://link.springer.com/article/10.1186/s13014-019-1323-z |
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