Postoperative Radiotherapy in Salivary Gland Carcinoma: A Single Institution Experience.
Gulf J Oncolog. 2017 Jan;1(23):26-32
Authors: Temelli Ö, Kekilli E, Kizilay A
BACKGROUND: Salivary gland carcinoma are rare tumors and the main treatment is surgical. The addition of radiotherapy to surgery decreases locoregional relapses in high risk patients. Aim of our study is to retrospectively evaluate local control and survival and the factors affecting them in patients who received postoperative radiotherapy.
MATERIALS AND METHODS: The medical records of 30 patients with salivary gland tumors operated on and referred to our clinic for adjuvant RT between January 2004 and June 2015 were retrospectively evaluated. RT was applied to the primary tumor or its lymphatics in a median dose of 60 Gy (48-66 Gy) in 1.8-2 Gy/fraction. The number of patients receiving concomitant chemotherapy was 8 (27%) and 22 (73%), respectively.
RESULTS: The mean duration of follow-up was 47 months (range: 3-132 months). The mean duration between surgery and RT was 51 days and mean duration of RT was 43 days. Tumors were located in the parotid gland in 25 patients (83%), in the submandibular gland in four patients (14%), and in the sublingual gland in one patient (3%). Histopathologically, the most common tumor was adenoid cystic carcinoma (27%), followed by mucoepidermoid carcinoma (20%), and skin SCC metastatic to the parotid gland. Five-year overall survival (OS), five-year disease specific survival (DSS), and five-year disease free survival (DFS) were 50%, 50%, and 54%, respectively. Regional recurrence and distant organ metastasis developed in 5 (17%) and 9 (30%) patients, respectively. OS, DSS, and DFS were significantly decreased in patients with lymph node metastasis compared to the patients with no metastasis (p=0.002). DFS was better in Stage 1-2 patients compared to Stage 3-4 patients (p=0.019). OS and DFS were significantly in radiotherapy time in less than 45 days (p=0.01). A duration between surgery and radiotherapy of more than 42 days was associated with low DFS (p=0.042). No prognostic significance of age, gender, type of the salivary gland, T stage, tumor diameter, surgical margin, PNI, LVI, and extracapsular involvement was found among the other variables.
CONCLUSION: Adjuvant RT is an efficacious and safe method of treatment in high risk patients operated on for salivary gland tumor.
PMID: 28271999 [PubMed - in process]