Abstract：
OBJECTIVE: This study aimed to analyze the treatment outcomes of single-fraction stereotactic radiosurgery (SRS) for adenoid cystic carcinoma patients.
METHODS: Retrospective analysis was conducted for 55 patients with 66 lesions. SRS intentions were categorized as definitive, adjuvant, salvage, and palliative. Tumor control was defined as local (within 50% isodose line), marginal (outside 50% isodose line), and distant (metastasis outside head/neck).
RESULTS: The median age was 60 years (range 21-85), with 53% males. Tumor origin was head/neck for 88% and trachea/lung for 12%. 61% were recurrent lesions. Median interval from diagnosis to SRS was 14 months. Preceding surgery was performed in 30%. SRS was administered as definitive (30 lesions), adjuvant (13), salvage (19), and palliative (4). SRS was used as a boost to external beam radiation therapy (EBRT) in 39%. Concurrent chemotherapy was administered in 26%. 5-, 10-, and 15-year local control rates were 60%, 33%, and 27%, respectively; local/marginal control rates were 29%, 13%, and 10%. For recurrent lesions treated with SRS without EBRT, 5-year local control rate was 14%, and local/marginal control rate was 5%. For recurrent lesions treated with SRS and EBRT, 5-year local control rate was 100%, and local/marginal control rate was 40%. The rate of distant failure after SRS was 40%. Older age and distant metastasis before SRS were negative factors for overall survival.
CONCLUSIONS: SRS provided a high rate of local tumor control, but marginal failure was frequent. Integrating SRS with added EBRT exhibits potential for enhancing local and local/marginal tumor control, particularly in recurrent cases.
METHODS: Retrospective analysis was conducted for 55 patients with 66 lesions. SRS intentions were categorized as definitive, adjuvant, salvage, and palliative. Tumor control was defined as local (within 50% isodose line), marginal (outside 50% isodose line), and distant (metastasis outside head/neck).
RESULTS: The median age was 60 years (range 21-85), with 53% males. Tumor origin was head/neck for 88% and trachea/lung for 12%. 61% were recurrent lesions. Median interval from diagnosis to SRS was 14 months. Preceding surgery was performed in 30%. SRS was administered as definitive (30 lesions), adjuvant (13), salvage (19), and palliative (4). SRS was used as a boost to external beam radiation therapy (EBRT) in 39%. Concurrent chemotherapy was administered in 26%. 5-, 10-, and 15-year local control rates were 60%, 33%, and 27%, respectively; local/marginal control rates were 29%, 13%, and 10%. For recurrent lesions treated with SRS without EBRT, 5-year local control rate was 14%, and local/marginal control rate was 5%. For recurrent lesions treated with SRS and EBRT, 5-year local control rate was 100%, and local/marginal control rate was 40%. The rate of distant failure after SRS was 40%. Older age and distant metastasis before SRS were negative factors for overall survival.
CONCLUSIONS: SRS provided a high rate of local tumor control, but marginal failure was frequent. Integrating SRS with added EBRT exhibits potential for enhancing local and local/marginal tumor control, particularly in recurrent cases.
摘要：
目的：本研究旨在分析单级立体定向放射外科（SRS）对腺样囊性癌患者的治疗效果。
方法：回顾性分析55例66个病灶。SRS意图被归类为确定的，佐剂,打捞,和姑息。肿瘤对照定义为局部（在50%等剂量线内），边缘(50%等剂量线之外)，和远处（头/颈部外转移）。
结果：中位年龄为60岁（范围21-85），53%的男性。肿瘤来源为头部/颈部占88%,气管/肺占12%。61%为复发病灶。从诊断到SRS的中位间隔为14个月。30％的患者进行了前手术。SRS作为确定性（30个病变），佐剂（13），打捞(19),姑息治疗（4）。在39%中使用SRS作为外部束放射治疗(EBRT)的增强。同时化疗的比例为26%。5-,10-,15年的地方控制率为60%，33%,27%,局部/边际控制率分别为29%，13%,和10%。对于使用SRS治疗而不使用EBRT的复发性病变，5年局部控制率为14%，局部/边际控制率为5%。对于使用SRS和EBRT治疗的复发性病变，5年局部控制率为100%,局部/边际控制率为40%。SRS后的远处失败率为40％。SRS前的年龄和远处转移是总体生存的负面因素。
结论：SRS提供了较高的局部肿瘤控制率，但是边际失败很频繁。将SRS与增加的EBRT整合具有增强局部和局部/边缘肿瘤控制的潜力。特别是在复发病例中。
方法：回顾性分析55例66个病灶。SRS意图被归类为确定的，佐剂,打捞,和姑息。肿瘤对照定义为局部（在50%等剂量线内），边缘(50%等剂量线之外)，和远处（头/颈部外转移）。
结果：中位年龄为60岁（范围21-85），53%的男性。肿瘤来源为头部/颈部占88%,气管/肺占12%。61%为复发病灶。从诊断到SRS的中位间隔为14个月。30％的患者进行了前手术。SRS作为确定性（30个病变），佐剂（13），打捞(19),姑息治疗（4）。在39%中使用SRS作为外部束放射治疗(EBRT)的增强。同时化疗的比例为26%。5-,10-,15年的地方控制率为60%，33%,27%,局部/边际控制率分别为29%，13%,和10%。对于使用SRS治疗而不使用EBRT的复发性病变，5年局部控制率为14%，局部/边际控制率为5%。对于使用SRS和EBRT治疗的复发性病变，5年局部控制率为100%,局部/边际控制率为40%。SRS后的远处失败率为40％。SRS前的年龄和远处转移是总体生存的负面因素。
结论：SRS提供了较高的局部肿瘤控制率，但是边际失败很频繁。将SRS与增加的EBRT整合具有增强局部和局部/边缘肿瘤控制的潜力。特别是在复发病例中。
