Topics:
Head and Neck Cancers • Radiation Oncology
How would you approach a laryngeal adenoid cystic carcinoma in a patient seeking larynx preservation?
What dose, fractionation, and volume would you choose?
Would you electively cover the vagal nerve(s) and associated recurrent laryngeal nerves?
Does your approach differ between early (T1-2N0) vs. locally advanced (T3-4a) cases or N0 vs. N+?
Answer from: Radiation Oncologist at Academic Institution
This is a rare case scenario (laryngeal ACC) in a rare cancer (ACC) of an uncommon group of malignancies (primary salivary gland malignancies) for which direct evidence is sparse. I would, therefore, approach with some general principles and a generous pinch of salt in this scenario. The initial tre...
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Answer from: Radiation Oncologist at Academic Institution
I have treated 2 patients definitively with primary laryngeal ACC who declined laryngectomy. Both had excellent local control to 70 Gy but both progressed with distant metastatic disease to the lung (and liver in 1 patient).
Comments
Radiation Oncologist at St Joseph Heritage Healthcare
What treatment volumes/expansions did you use?
What treatment volumes/expansions did you use?
Radiation Oncologist at University of Washington
Use neutron RT. That’s the best for gross dz...
Use neutron RT. That’s the best for gross dz...
Answer from: Radiation Oncologist at Academic Institution
Partial laryngectomy
2/21/2024
Definitive RT
Answer from: Radiation Oncologist at Community Practice
Pre-op chemotherapy/immunotherapy, follow with partial laryngectomy if possible, or if no surgery, treat with neutron therapy — treat with post op XRT (if partial laryngectomy is possible.) And, for all the above options, consider long term post therapy chemotherapy/immunotherapy.