Abstract
PurposeTo evaluate the efficacy and safety of carbon-ion radiotherapy (CIRT) for patients with lacrimal gland carcinomas (LGCs) with extraorbital extensionResultsThe median follow-up period was 53.7 months. The 5-year local control and overall survival rates were 62% and 65%, respectively. Regarding late toxicities, 12 patients (36.4%) developed Grade 4 optic nerve disorders, including visual losses of the diseased side (N = 8; 66.7%), and 1 patient (3.0%) developed a Grade 3 optic nerve disorder. Three patients (9.0%) developed Grade 3 cataracts, 3 (9.0%) developed glaucoma, and 1 (3.0%) developed retinopathy. Two patients (6.1%) had Grade 4 central nervous system necrosis. No Grade 5 late toxicities were observed. The 5-year preservation rate of the ipsilateral eyeball was 86%.ConclusionDefinitive CIRT is effective for LGCs with extraorbital extension with acceptable toxicity.MethodsThirty-three patients treated with CIRT at our institution were analyzed. Sixteen patients (48.5%) had adenoid cystic carcinoma, 8 (24.2%) had adenocarcinoma not otherwise specified, and 9 (27.3%) had other types of the disease. Thirty patients (90.9%) had T4c tumors. The prescribed doses were 57.6 Gy (relative biological effectiveness [RBE]) (N = 18; 54.5%) and 64.0 Gy (RBE) (N = 15; 45.5%) in 16 fractions.
Highlights
Lacrimal gland carcinoma (LGC) is a relatively rare disease with an annual incidence of 0.19 per 1,000,000 population in Denmark [1]
Definitive carbon-ion radiotherapy (CIRT) is effective for LGCs with extraorbital extension with acceptable toxicity
LGC represents a diverse range of histological subtypes, including radioresistant tumors, such as adenoid cystic carcinoma and ductal adenocarcinoma
Summary
Lacrimal gland carcinoma (LGC) is a relatively rare disease with an annual incidence of 0.19 per 1,000,000 population in Denmark [1]. LGC represents a diverse range of histological subtypes, including radioresistant tumors, such as adenoid cystic carcinoma and ductal adenocarcinoma. The therapeutic management of LGCs includes surgery and additional adjuvant chemoradiotherapy or radiotherapy depending on disease stage, histological subtype, the presence or absence of perineural invasion, incomplete surgical resection, involvement of regional lymph nodes, and extracapsular spread [2]. The majority of the patients with LGCs with extraorbital extension are inoperable. With regard to alternative treatment modalities, photon radiotherapy was shown to be inferior to surgery because histological subtypes, such as adenoid cystic carcinoma and ductal adenocarcinoma, are radioresistant [1, 5], and an effective chemotherapeutic regimen is yet to be established [2]. There are no effective treatment methods for inoperable LGCs or patients who refuse surgery
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