Chemotherapy for recurrent adeno- and adenoidcystic carcinomas in the head and neck

Abstract

We have investigated the effectiveness of chemotherapy for patients with recurrent adeno- and adenoidcystic carcinomas in the head and neck. Fourteen cases received a monthly combination chemotherapy regimen of cyclophosphamide, pirarubicin and cisplatin (CAP therapy). A response rate of 36% (5/14) was achieved. There was one complete response and four partial responses. The median duration of response was 37 months in the complete response case and 16 months (range, 6 to 20) in the partial response cases. The toxicity of this chemotherapy was acceptable. The result demonstrates that CAP therapy is an effective regimen for adeno- and adenoidcystic carcinomas. It may also be available as induction or adjuvant chemotherapy for patients with advanced tumors of these cancers.

Stereotactic Radiosurgery as a Salvage Treatment for Recurrent Skull Base Adenoid Cystic Carcinoma

“…The diffi culty in treating recurrent ACC involving the skull base has led investigators to consider additional treatments beyond conventional surgery and radiation therapy. However, chemotherapy is largely ineffective in this setting [2,4] . Tsukuda et al [4] reported that the response rate of IAP (cyclophosphamide, pirarubicin and cisplatin) therapy was only 33% in 6 recurrent ACC in the head and neck.…”

“…However, chemotherapy is largely ineffective in this setting [2,4] . Tsukuda et al [4] reported that the response rate of IAP (cyclophosphamide, pirarubicin and cisplatin) therapy was only 33% in 6 recurrent ACC in the head and neck. SRS for various brain tumor histologies has been investigated by a number of institutions [5,6] .…”

“…Surgical resection and conventional radiotherapy are initially effective methods for local control at the primary site but skull base tumor recurrence can occur many years after diagnosis and primary treatment [2] . Chemotherapy is largely ineffective in this setting [2][3][4] . Though reirradiation may be benefi cial, especially at high doses, delivering high doses of radiotherapy to a previously irradiated area, surrounded by vital nerve tissue and brain, may be problematic.…”

Carcinoma Ex Pleomorphic Adenoma: Case Report and Options for Systemic Therapy

“…The choice of therapy was based on several small phase ii studies identifying that combination as active in the treatment of malignant salivary gland tumours, although with efficacy varying by histologic subtype [10][11][12] . Newer combinations such as carboplatin-paclitaxel or cisplatin-gemcitabine have demonstrated moderate activity in small trials involving salivary gland tumours with a mix of histologies 13,14 .…”

Neoadjuvant Intracarotid Chemotherapy for Treatment of Advanced Adenocystic Carcinoma of the Lacrimal Gland

“…Schramm and colleagues 35 used cisplatin as a single agent in a pilot study and reported an overall response rate of 70%. Two other studies of recurrent salivary gland epithelial tumors revealed response rates of 36% 36 (cisplatin combined with cyclophosphamide and pirarubicin) and 35% 37 (cisplatin combined with doxorubicin and fluorouracil). These response rates were achieved despite the fact that the patients had a poor prognosis due to advanced tumor involvement.…”