Treatment for Carcinoma, Adenoid Cystic

1
Effectiveness
1
Safety
Massachusetts General Hospital, Boston, MA
Carcinoma, Adenoid Cystic+11 More
Eligibility
18+
All Sexes
Eligible conditions
Carcinoma, Adenoid Cystic

Study Summary

Intensity-Modulated or Proton Radiation Therapy for Sinonasal Malignancy

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Eligible Conditions

  • Carcinoma, Adenoid Cystic
  • Esthesioneuroblastoma, Olfactory
  • Carcinoma
  • Carcinoma, Mucoepidermoid
  • Melanoma
  • Sinonasal Carcinoma
  • Myoepithelial Carcinoma
  • Sinonasal Undifferentiated Carcinoma
  • Esthesioneuroblastoma
  • Mucoepidermoid Carcinoma
  • Squamous Cell Carcinoma (SCC)
  • Schneiderian Carcinoma

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Treatment will improve 1 primary outcome and 7 secondary outcomes in patients with Carcinoma, Adenoid Cystic. Measurement will happen over the course of 2 years.

2 years
Local Control Rates
Regional control
5 years
Local control
Neurocognitive function
Patterns of Tumor Relapse
QOL
Survival
Vision preservation

Trial Safety

Trial Design

2 Treatment Groups

IMRT

This trial requires 90 total participants across 2 different treatment groups

This trial involves 2 different treatments. Treatment is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

IMRT
Radiation
Intensity-modulated radiation therapy at institutions other than Massachusetts General Hospital
Proton beam therapy
Radiation
Subjects treated at Massachusetts General Hospital with proton beam therapy

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 5 years
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 5 years for reporting.

Who is running the study

Principal Investigator
A. W. C.
Prof. Annie W. Chan, MD
Massachusetts General Hospital

Closest Location

Massachusetts General Hospital - Boston, MA

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 6 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
Eastern cooperative oncology group (ECOG) performance status 0 - 1 or Karnofsky Performance Status ≥ 70. (Appendix B)
All patients must undergo pre-treatment evaluation of tumor extent prior to study entry through imaging studies and clinical examinations, including CT and/or MRI of skull base, brain and neck within 28 days prior to study entry; physical examination +/- nasal endoscopy within 28 days prior to study entry; and CT of the chest within 60 days prior to study entry.
Nutritional and general physical condition must be considered compatible with the proposed radiation +/- chemotherapy treatment.
Biopsy proven, within 16 weeks prior to study entry, sinonasal adenoid cystic carcinoma, adenocarcinoma, mucoepidermoid carcinoma, squamous cell carcinoma, including sinonasal carcinoma, sinonasal undifferentiated carcinoma, Schneiderian carcinoma, myoepithelial carcinoma, undifferentiated carcinoma, esthesioneuroblastoma, or melanoma AJCC 7th edition Stage III - IVA/B tumors, or with skull base or intracranial extension. Pathology must be confirmed by review at the treating institution.
Patients with biopsy proven locally advanced sinus, nasal cavity, hard palate, soft palate, major or minor salivary gland tumors, or lacrimal apparatus, with nasal cavity, sinus, auditory canal, or skull base involvement are eligible.
Normal organ and marrow function

Patient Q&A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

How quickly does carcinoma, adenoid cystic spread?

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Results from a recent clinical trial suggest that adenoma, carcinoma is an aggressive disease, and that it has spread to mediastinal lymph nodes. Our patients who underwent pleural aspiration should be carefully follow-up with radiological findings.

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What is carcinoma, adenoid cystic?

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Carcinoma, adenoid cystic can be benign (adenomyoepithelial) or malignant (carcinoma) (cancer in situ). In the former case, surgical excision followed by radiotherapy is justified, in the latter case chemotherapy and then radiotherapy are necessary.

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Can carcinoma, adenoid cystic be cured?

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Cancers that have not metastasized are not always curable at the time of diagnosis; therefore, a wide surgical excision in combination with systemic chemotherapy may be indicated.

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How many people get carcinoma, adenoid cystic a year in the United States?

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Around 14,000 to 37,000 cases of ACC are diagnosed each year in the United States. The incidence of cancer of the ACC appears stable during the last 3 decades.

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What are common treatments for carcinoma, adenoid cystic?

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The treatment for cancer varies according to the tumor type. For malignant neoplasms involving bone, the treatments usually involve radiotherapy and surgery. For carcinoma, radiation therapy and chemotherapy are usually considered to be the treatments. For adenoid cystic carcinoma, radiation or surgery is generally suggested.

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What causes carcinoma, adenoid cystic?

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About 30% of carcinomas and 10% of adenoid cystic tumors are inherited. Carcinoma and adenoid cystic tumours are often polyfunctional genetic disorders, and several of them are caused by mutations in mismatch repair genes. The high frequency of inherited mutations in tumours suggests that a significant proportion of carcinoma and adenoid cystic tumours are caused by somatic mistakes during DNA repair. However, adenoma and carcinomas caused by germline mutations in DNA repair genes are rare (2%). The remainder (60%) in our cohort were probably caused by somatic mutations following the disruption of the DNA-repair process. These tumours are probably more often associated with somatic mutations than germline mutations.

Unverified Answer

What are the signs of carcinoma, adenoid cystic?

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The American Joint Committee on Cancer provided a system to classify cancers based on the morphology at diagnosis. The presence of a well circumscribed mass at presentation was the first and the second most common indicator of malignancy in carcinoma, adenoid cystic. In carcinoma, adenoid cystic, presence of lymphadenopathy or bone marrow involvement was also noted as indicators of malignancy. Clinically, there was no reliable sign/symptom of malignancy. The first line treatment in all cases remains surgical, with a significant survival benefit. The most common cause for death in this group is related to lung cancer.

Unverified Answer

What is the primary cause of carcinoma, adenoid cystic?

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Results from a recent clinical trial suggest that the prevalence ratio of ADE might be higher than the prevalence ratio of carcinoma in the present study. They also raise the possibility of the presence of a new tumor entity in ADE group in addition to the previously established disease entity. However, the exact cause(s) of this association remains to be determined.

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Who should consider clinical trials for carcinoma, adenoid cystic?

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Results from a recent paper, the patients aged 60 years or older, or women with malignant tumor, or history of recent malignancy, or lymph node tumor or radiotherapy, or current treatment of metastatic malignancy, had a higher response rate than all other subgroups. The elderly, women, and patients with a history of cancer or metastases should consider clinical trials for cancer.

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Has treatment proven to be more effective than a placebo?

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The number of years of OS was significantly better in the TP group, so we conclude that treatments, such as radiotherapy, that have proven to be more effective than a placebo are also more effective than a placebo.

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What does treatment usually treat?

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The findings reported herein may have direct and indirect clinical applications in the prevention of disease progression and clinical presentation. The role of adjuvant and neoadjuvant chemotherapy in the treatment of locally advanced carcinoma of the middle ear is a topic for further study.

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What are the latest developments in treatment for therapeutic use?

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In response to the high incidence of metastases, patients are now being diagnosed and treated before the disease has developed metastases. In the Netherlands, treatment is often offered within weeks of the diagnosis. A combination therapy with anti-neoplastic agents, including paclitaxel (Taxol), vinorelbine (Elvogel), carboplatin (CBDCan), and the investigational inhibitor MK-2217 (Palbociclib) is now available and can help reduce the risk of the spread in Stage IV disease and prolong patient survival.

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