{
  "abstract": "Background: Adenoid cystic carcinoma (ACC) is a rare malignancy characterized by indolent growth, frequent perineural invasion, and a propensity for locally advanced disease involving the skull base. High-dose radiation to complex target volumes must be balanced with minimizing exposure to adjacent organs at risk, making particle therapy attractive. Proton beam therapy (PBT) and carbon ion radiotherapy (CIRT) provide favorable dose distributions compared with photon-based radiotherapy, while CIRT offers additional theoretical radiobiologic advantages through its higher linear energy transfer and relative biological effectiveness. However, whether these properties translate into superior clinical outcomes remains uncertain.\n\nMethods: This perspective reviews physical and radiobiologic characteristics of PBT and CIRT and evaluates contemporary clinical evidence supporting their use in ACC. Available studies demonstrate favorable local control, overall survival, and toxicity outcomes with both modalities but have not established a clear clinical advantage of CIRT over modern PBT. Interpretation is limited by heterogeneous patient populations, treatment techniques, fractionation schedules, institutional practices, follow-up, and the absence of prospective data. Additionally, differences in infrastructure, cost, geographic availability, and reimbursement influence treatment selection and patient access.\n\nResults: Current evidence supports PBT as an efficacious and broadly applicable treatment option for ACC, particularly for complex skull base and perineural target volumes. Future research should prioritize comparative dosimetry, refinement of biologic dose modeling, multicenter clinical outcomes, contemporary cost-effectiveness analyses, and patient selection. Expanding equitable access to particle therapy should remain a parallel objective.\n\nConclusion: Current literature supports PBT in the treatment of ACC. Reported treatment outcomes are comparable to CIRT.",
  "abstract_shown": true,
  "affiliations": [
    "Drexel University College of Medicine, Philadelphia, PA, United States",
    "Mayo Clinic in Florida Department of Radiation Oncology, Jacksonville, FL, United States",
    "University of North Carolina Department of Radiation Oncology, Chapel Hill, NC, United States",
    "Mayo Clinic Minnesota Department of Radiation Oncology, Rochester, MN, United States",
    "University of Florida Proton Therapy Institute, Jacksonville, FL, United States",
    "Radiation Oncology Unit, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy",
    "Hong Kong Sanitorium Hospital, Comprehensive Oncology Centre, Hong Kong, Hong Kong SAR, China",
    "Corewell Health, Royal Oak, MI, United States",
    "Mayo Clinic Arizona, Scottsdale, AZ, United States",
    "Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States",
    "Gunma University Heavy Ion Medical Center, Gunma, Japan",
    "Memorial Sloan Kettering Cancer Center, New York, NY, United States"
  ],
  "article_type": "brief report",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Astha Rohit"
    },
    {
      "affs": [
        1
      ],
      "name": "Adam Holtzman"
    },
    {
      "affs": [
        2
      ],
      "name": "James Bates"
    },
    {
      "affs": [
        3
      ],
      "name": "Scott Lester"
    },
    {
      "affs": [
        4
      ],
      "name": "Roi Dagan"
    },
    {
      "affs": [
        5
      ],
      "name": "Barbara Vischioni"
    },
    {
      "affs": [
        5
      ],
      "name": "Ester Orlandi"
    },
    {
      "affs": [
        5
      ],
      "name": "Maria Bonora"
    },
    {
      "affs": [
        6
      ],
      "name": "Amy Tien Yee Chang"
    },
    {
      "affs": [
        7
      ],
      "name": "Rohan Deraniyagala"
    },
    {
      "affs": [
        8
      ],
      "name": "Martin Bues"
    },
    {
      "affs": [
        9
      ],
      "name": "Steven Frank"
    },
    {
      "affs": [
        8
      ],
      "name": "Samir H. Patel"
    },
    {
      "affs": [
        10
      ],
      "name": "Atsushi Musha"
    },
    {
      "affs": [
        10
      ],
      "name": "Tatsuya Ohno"
    },
    {
      "affs": [
        11
      ],
      "name": "Nancy Lee"
    },
    {
      "affs": [
        8
      ],
      "name": "Lisa McGee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/13nmbnktapn6d.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1979803",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696287/",
  "id": "13nmbnktapn6d",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://doi.org/10.3389/fonc.2026.1979803",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Perspective"
    ],
    [
      "openalex",
      "2740|Radiation Therapy and Dosimetry"
    ]
  ],
  "openalex": "W7221459881",
  "pdf_url": "https://europepmc.org/articles/PMC13696287?pdf=render",
  "pmcid": "PMC13696287",
  "pmid": "42935547",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/13nmbnktapn6d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:40Z",
      "native_id": "PMC13696287",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fonc.2026.1979803"
    },
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1979803",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1979803/full"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935547",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935547"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "Revisiting proton therapy for adenoid cystic carcinoma: a case worth making",
  "title_text": "Revisiting proton therapy for adenoid cystic carcinoma: a case worth making",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:39Z",
  "url": "https://research.draconitic.com/paper/13nmbnktapn6d",
  "venue": "Frontiers in Oncology",
  "versions": []
}