目的：研究接受治疗性再次放射治疗（reRT）的头颈部腺样囊性癌（HNACC）患者的治疗结果，其中采用强度调控放射治疗（IMRT）或质子治疗（PT）治疗无法切除的复发或二次原发性HNACC。方法：自2011年7月至2021年11月，对10名经验值超过90%的患者（其中3名采用IMRT，7名采用PT）进行了再次放射治疗，CTV的中位最大剂量为64.2 Gy。再次放射治疗时的肿瘤部位主要为鼻窦（4/10）和唾液腺（包括腮腺和颌下腺，3/10）。我们使用CTCAEv5标准来评估急性和迟发性毒性反应。以治疗结束至最后一次随访日期之间的时间为随访时间。结果：两次放疗之间的中位时间为53.5个月（IQR：18-84）。经过中位随访时间26个月（范围，12.5-51.8个月），有6名患者出现局部区域复发（LR），其中4名发生在先前放疗过的区域。2年和3年的局部区域失败无病存活率（LFFS）和总体生存率（OS）分别为55.6% [95%CI：31%-99.7%]，66.7% [42%-100%]和41% [18.5%-94%]，44.4% [21.4%-92.3%]。在鼻窦肿瘤亚组（p=0.013）和第一次放疗后2年以上再次放疗的患者亚组（p=0.01）中，LFFS和OS明显更好。在再次放疗开始之前，有7名患者存在损伤，包括听力损伤（3/10）和面神经损伤（3/10）。最严重的迟发性毒性反应包括脑坏死（2/10），放射性骨坏死（1/10）和视力下降（1/10）。结论：对于特定病例，HNACC的治疗性再次放射治疗是可行的，但放疗区域内的局部复发率和严重毒性风险仍然很高。改进选择标准和更精确定义的靶区可能会改善这些患者的治疗效果。进一步研究包括更大的患者队列将有助于确认这些结果。

To investigate the outcomes of patients who underwent curative reirradiation (reRT), with intensity-modulated radiation therapy (IMRT) or proton therapy (PT) for unresectable recurrent or second primary head and neck adenoid cystic carcinoma (HNACC).Ten patients, mostly KPS 90%, were reirradiated (3/10 with IMRT and 7/10 with PT) at a median maximum dose to the CTV of 64.2 Gy from July 2011 to November 2021. Locations at the time of reRT were mainly the sinus (4/10) and the salivary glands (including the parotid and submandibular gland, 3/10). CTCAEv5 was used to assess acute and late toxicities. Follow-up was the time between the end of reRT and the date of last news.The median time between the two irradiations was 53.5 months (IQR:18 - 84). After a median follow-up of 26 months (range, 12.5-51.8 months), six patients had developed a locoregional recurrence (LR), of which four occurred within the previously irradiated volume. Two and three-year locoregional failure-free survival (LFFS) and overall survival (OS) were 55.6% [95%CI:31%-99.7%], and 41% [18.5%-94%] and 66.7% [42%-100%] and 44.4% [21.4%-92.3%], respectively. LFFS and OS were significantly better in the subgroup of sinus tumors (p = 0.013) and the subgroup of patients re-irradiated more than two years after the first course of irradiation (p = 0.01). Seven patients had impairments before the start of reRT, including hearing impairment (3/10) and facial nerve impairment (3/10). The most severe late toxicities were brain necrosis (2/10), osteoradionecrosis (1/10) and vision decreased (1/10).Curative reRT for HNACC is possible for selected cases, but the LR rate in the irradiated field and the risk of severe toxicity remain high. Improved selection criteria and more carefully defined target volumes may improve outcome in these patients. A further study including larger cohort of patients would be useful to confirm these results.