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CASE REPORT article

Front. Oncol.

Sec. Radiation Oncology

This article is part of the Research TopicRecent Advances in Radiation Oncology for the Management of Thoracic MalignanciesView all 17 articles

Definitive radiotherapy for adenoid cystic carcinoma of main bronchus: A case report with 10-year follow-up

Provisionally accepted
Sunghyun NamSunghyun Nam1Hyungsoon KimHyungsoon Kim1Doyoon KimDoyoon Kim1Jihoon MaengJihoon Maeng1Hyo Sup ShimHyo Sup Shim2Dae Joon KimDae Joon Kim3Eun Young KimEun Young Kim4Min Hee HongMin Hee Hong5Seo Hee ChoiSeo Hee Choi6*Jaeho ChoJaeho Cho6*
  • 1College of Medicine, Korea University, Seoul, Republic of Korea
  • 2Department of Pathology, Severance Hospital, College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea
  • 3Department of Thoracic Surgery, College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea
  • 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea
  • 5Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea
  • 6Department of Radiation Oncology, College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea

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Introduction: Tracheal adenoid cystic carcinoma (ACC) is a rare malignancy with a slow but relentless course. Surgical resection is the standard treatment, but in cases where surgery is not feasible, definitive radiotherapy serves as an alternative approach. Case Description: We report the case of a 55-year-old female patient diagnosed with unresectable ACC of the left main bronchus near the carina. Due to the high surgical risk of pneumonectomy with carinal reconstruction, the patient was treated with definitive intensity-modulated radiation therapy (IMRT) using a simultaneous integrated boost technique. A total dose of 69 Gy in 30 fractions was delivered. The patient tolerated the treatment well without significant acute or late complications. Follow-up imaging demonstrated a durable local response, with near-complete remission of the primary tumor. Ten years post-treatment, the patient remains free of local recurrence, with slow-progressing pulmonary metastases under surveillance. Conclusion: This case highlights the potential of definitive IMRT using a hypofractionated dose scheme in achieving long-term local control for unresectable tracheal ACC.

Keywords: Adenoid cystic carcinoma, case report, Radiotherapy, intensity-modulatedradiotherapy, Tracheal neoplasm

Received: 09 Apr 2025; Accepted: 30 Nov 2025.

Copyright: © 2025 Nam, Kim, Kim, Maeng, Shim, Kim, Kim, Hong, Choi and Cho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Seo Hee Choi
Jaeho Cho

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