Long-term outcomes of globe-sparing surgery combined with adjuvant radiotherapy for lacrimal gland adenoid cystic carcinoma
Abstract
PurposeTo evaluate long-term outcomes of radiotherapy after globe-sparing surgery for lacrimal gland adenoid cystic carcinoma (LGACC) and compare different radiotherapy protocols.MethodsThis retrospective comparative case series included 97 patients with LGACC treated with globe-sparing surgery followed by postoperative radiotherapy between November 2003 and April 2023. Patients received one of four protocols differing in clinical target volume (CTV) expansion and radiation dose. Primary outcomes included locoregional recurrence, distant metastasis, locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival, and overall survival.ResultsThe median age was 38 years, and median follow-up was 7.2 years. The overall 5-, 10-, and 15-year LRFS rates were 80.2%, 74.5%, and 74.5%, respectively. Multivariable analysis identified R2 resection (HR = 4.16, 95% CI: 1.53‑11.35, P = 0.005), cribriform histology (HR = 0.26, 95% CI: 0.08‑0.81, P = 0.020), and smaller CTV expansion (≤0.5 cm; HR = 4.06, 95% CI: 1.41‑11.67, P = 0.009) as independent predictors of local recurrence. Patients treated with ≤0.5-cm CTV expansion and ≤54 Gy had significantly lower 5-, 10-, and 15-year LRFS rates (55.2%, 40.5%, and 40.5%) than those treated with 1-cm CTV expansion and 60-80 Gy (90.5%, 90.5%, and 90.5%; P < 0.001). DMFS did not differ significantly between groups (P = 0.599). Best-corrected visual acuity of 20/20-20/40 was preserved in 35.1% of patients. The 5-year risk of radiation retinopathy was 25.1% and 43.6% (P = 0.057) in the no extended-margin and extended-margin groups, respectively.ConclusionsRadiotherapy with 1-cm CTV expansion and a dose of 60 Gy after globe-sparing surgery provided favorable locoregional control for LGACC. Distant metastasis remained the predominant cause of treatment failure.
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BibTeX
@article{zhao2026longterm,
title = {{Long-term outcomes of globe-sparing surgery combined with adjuvant radiotherapy for lacrimal gland adenoid cystic carcinoma}},
author = {Shui-Xi Zhao and Wen-Qin Xu and Xi-Hong Zhao and Dan Su and Yue-Yue Li and Rui Ma and Yan Hei and Xue-Tao Mu and Xin-Ji Yang},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1934640},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1934640},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Long-term outcomes of globe-sparing surgery combined with adjuvant radiotherapy for lacrimal gland adenoid cystic carcinoma
AU - Shui-Xi Zhao
AU - Wen-Qin Xu
AU - Xi-Hong Zhao
AU - Dan Su
AU - Yue-Yue Li
AU - Rui Ma
AU - Yan Hei
AU - Xue-Tao Mu
AU - Xin-Ji Yang
PY - 2026
DA - 2026/11/02
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1934640
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1934640
AB - PurposeTo evaluate long-term outcomes of radiotherapy after globe-sparing surgery for lacrimal gland adenoid cystic carcinoma (LGACC) and compare different radiotherapy protocols.MethodsThis retrospective comparative case series included 97 patients with LGACC treated with globe-sparing surgery followed by postoperative radiotherapy between November 2003 and April 2023. Patients received one of four protocols differing in clinical target volume (CTV) expansion and radiation dose. Primary outcomes included locoregional recurrence, distant metastasis, locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival, and overall survival.ResultsThe median age was 38 years, and median follow-up was 7.2 years. The overall 5-, 10-, and 15-year LRFS rates were 80.2%, 74.5%, and 74.5%, respectively. Multivariable analysis identified R2 resection (HR = 4.16, 95% CI: 1.53‑11.35, P = 0.005), cribriform histology (HR = 0.26, 95% CI: 0.08‑0.81, P = 0.020), and smaller CTV expansion (≤0.5 cm; HR = 4.06, 95% CI: 1.41‑11.67, P = 0.009) as independent predictors of local recurrence. Patients treated with ≤0.5-cm CTV expansion and ≤54 Gy had significantly lower 5-, 10-, and 15-year LRFS rates (55.2%, 40.5%, and 40.5%) than those treated with 1-cm CTV expansion and 60-80 Gy (90.5%, 90.5%, and 90.5%; P < 0.001). DMFS did not differ significantly between groups (P = 0.599). Best-corrected visual acuity of 20/20-20/40 was preserved in 35.1% of patients. The 5-year risk of radiation retinopathy was 25.1% and 43.6% (P = 0.057) in the no extended-margin and extended-margin groups, respectively.ConclusionsRadiotherapy with 1-cm CTV expansion and a dose of 60 Gy after globe-sparing surgery provided favorable locoregional control for LGACC. Distant metastasis remained the predominant cause of treatment failure.
SN - 2234-943X
ER -