{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:06:20Z","timestamp":1791821180467,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"LOEWE\u2014Landes-Offensive zur Entwicklung Wissenschaftlich-\u00f6konomischer Exzellenz","award":["LOEVWE\/2\/16\/519\/03\/09.001(0001)\/101"],"award-info":[{"award-number":["LOEVWE\/2\/16\/519\/03\/09.001(0001)\/101"]}]},{"name":"Mildred Scheel Early Career Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background and Purpose: This study retrospectively evaluates the outcomes of head and neck adenoid cystic carcinomas (ACCs) treated with particle therapy, including carbon ion radiotherapy (CIRT) alone or combined with photon therapy, at a single institution. Methods and Materials: Patients with ACC who underwent CIRT alone or a combination of CIRT and photon therapy at the Marburg Ion Therapy Center between February 2017 and December 2023 were included. Radiation therapy was administered postoperatively in surgically resectable patients and as definitive treatment in unresectable patients. Newly diagnosed patients received CIRT as a boost in combination with photon intensity-modulated radiation therapy (IMRT), while those with recurrent disease received CIRT alone. Prognostic factors were analyzed using Kaplan\u2013Meier analysis and proportional hazards regression for multiple regression. Late toxicities (grade 3 or higher) were recorded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4. Results: A total of 73 patients were included, with a median age of 57 years (range: 16\u201386 years) and a median follow-up of 20 months (range: 3\u201370 months). The cohort included 28 males (38%) and 45 females (62%). The median CIRT dose was 24 Gy (relative biological effectiveness (RBE)) (range: 15\u201360 Gy) in a median of 8 fractions (range: 5\u201320), and the median photon dose was 50 Gy (range: 45\u201354 Gy) in 25 fractions (range: 15\u201330). Locoregional recurrence-free survival rates at 1 and 3 years were 89.6% and 75.4%, respectively, while distant metastasis-free survival rates were 82.1% and 61.4%, respectively. LC was significantly influenced by T stage, with patients with T4 tumors showing worse outcomes. Treatment was generally well tolerated, with acute side effects including mucositis and skin erythema. Severe chronic toxicities were rare, with only 1% of patients experiencing grade 3 dysphagia and grade 3 xerostomia. Conclusions: CIRT, particularly when combined with photon therapy, demonstrates favorable local control and promising efficacy in head and neck ACC, though distant metastasis remains the primary pattern of failure. Tumor stage is a significant negative prognostic factor for local control and overall survival.<\/jats:p>","DOI":"10.3390\/cancers18050753","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:58:03Z","timestamp":1772114283000},"page":"753","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Outcomes of Dual-Beam Particle Therapy in Head and Neck Adenoid Cystic Carcinoma"],"prefix":"10.3390","volume":"18","author":[{"given":"Gertrud","family":"Schmich","sequence":"first","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"},{"name":"Mildred Scheel Early Career Center (MSNZ) for Cancer Research Marburg-Frankfurt, University Hospital Marburg, 35037 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alwina","family":"Keil","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima Frosan","family":"Sheikhzadeh","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-6065","authenticated-orcid":false,"given":"Fabian","family":"Eberle","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Habermehl","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Giessen University Hospital, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3913-4693","authenticated-orcid":false,"given":"Thomas","family":"Held","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), NCT Heidelberg, A Partnership Between DKFZ and University Medical Center Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Lishewski","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris A.","family":"Stuck","sequence":"additional","affiliation":[{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universit\u00e4t Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilke","family":"Vorwerk","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5785-4101","authenticated-orcid":false,"given":"Klemens","family":"Zink","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"},{"name":"LOEWE Research Cluster for Advanced Medical Physics in Imaging and Therapy (ADMIT), TH Mittel Hessen University of Applied Sciences, 35390 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Adeberg","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"},{"name":"LOEWE Research Cluster for Advanced Medical Physics in Imaging and Therapy (ADMIT), TH Mittel Hessen University of Applied Sciences, 35390 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5557-7438","authenticated-orcid":false,"given":"Ahmed","family":"Gawish","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Philips University, 35037 Marburg, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Marburg Ion-Beam Therapy Center (MIT), Marburg University Hospital, 35043 Marburg, Germany"},{"name":"University Cancer Center (UCT) Frankfurt-Marburg, 35032 Marburg, Germany"},{"name":"LOEWE Research Cluster for Advanced Medical Physics in Imaging and Therapy (ADMIT), TH Mittel Hessen University of Applied Sciences, 35390 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.oraloncology.2015.04.005","article-title":"Adenoid cystic carcinoma of the head and neck\u2014An update","volume":"51","author":"Rodrigo","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4444","DOI":"10.1002\/cncr.27408","article-title":"Adenoid cystic carcinoma of the head and neck: Incidence and survival trends based on 1973\u20132007 Surveillance, Epidemiology, and End Results data","volume":"118","author":"Ellington","year":"2012","journal-title":"Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"37117","DOI":"10.18632\/oncotarget.5076","article-title":"Adenoid cystic carcinoma: Current therapy and potential therapeutic advances based on genomic 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