Patterns of care, toxicity and outcome in the treatment of salivary gland carcinomas: long-term experience from a tertiary cancer center

Grün, Jens von der; Winkelmann, Ria; Rödel, Franz; Balster, Sven; Neumayer, Thomas; Ghanaati, Shahram; Brandts, Christian; Burck, Iris; Martin, Daniel; Rödel, Claus; Kesar, Nikolina; Balermpas, Panagiotis

doi:10.1007/s00405-021-06652-5

Cited by 6 publications

(2 citation statements)

References 47 publications

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“…Лучевая терапия является неотъемлемой частью комбинированного лечения больных с местнораспространенными злокачественными опухолями слюнных желез. Объем облучения, суммарные очаговые дозы, а также эффективность лечения находятся в прямой зависимости от различных клинико-морфологических факторов, влияющих на прогноз течения заболевания [8,9]. Комбинированный метод лечения с послеоперационной фотонной лучевой терапией обеспечивает пятилетнюю продолжительность жизни у 50-85 % больных раком слюнных желез в зависимости от стадии, морфологического типа, а также локализации опухоли.…”

Section: Discussionunclassified

Combined Treatment of Salivary Gland Cancer Patients with the Use of High-Let Radiation

Gribova,

Startseva,

Choynzonov

et al. 2023

MEDICAL RADIOLOGY AND RADIATION SAFETY

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The purpose: To evaluate the efficiency of combined treatment of patients with salivary gland cancer using neutron therapy. Material and methods: The study included 130 patients with salivary gland cancer who underwent combined treatment with adjuvant neutron or standard photon radiotherapy. Neutron therapy was performed on a cyclotron U-120. The average energy of fast neutrons was 6.3 MeV. Results: There was observed a significant decrease in the frequency of relapses in the group of patients who received a postoperative course of NT compared with the control group (21.1 % vs. 45 %, p<0.05). The five-year overall survival in the study group was 73.8±9.5 %, in the control group ‒ 43.2±9.4% (p<0.05). The value of five-year relapse-free survival in the study group was 65.6±7.5 %, in the control group ‒ 34.8±9.1 % (p<0.05). Erythema of the skin in the irradiation area (grade I) was the most frequent type of local acute radiation reaction and was observed in 60 % of patients in the study group and in 25 % of patients in the control group. The most frequent late complication in both groups of patients was skin atrophy and subcutaneous fibrosis (grade I on the RTOG/EORTC scale). In the study group, this indicator was 34.4 %, in the control group ‒ 20 % (p>0.05). Conclusion: Thus, the study confirmed the high effectiveness of fast neutron therapy against malignant tumors of the salivary glands. Neutron therapy does not cause serious complications, encourages to increase of patients life expectancy and to decrease the number of relapses after combined treatment in comparison with standard methods of treatment.

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Section: Discussionunclassified

Combined Treatment of Salivary Gland Cancer Patients with the Use of High-Let Radiation

Gribova,

Startseva,

Choynzonov

et al. 2023

MEDICAL RADIOLOGY AND RADIATION SAFETY

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“…Salivary gland cancers (SGC) are rare tumors, representing 1–5% of all head and neck cancers and include a wide range of histological features and clinical behaviors, which makes diagnosis and treatment challenging 1 – 3 . Furthermore, the rarity of these tumors combined with the variable histology lead to a lack of studies that could provide strong recommendations for each individual histological subtype 4 . Taken together, both the rarity and the heterogeneity of these malignancies pose a great challenge that makes general recommendations and randomized trials if not impossible, at least insufficient.…”

Section: Introductionmentioning

confidence: 99%

MRI-based radiomics for predicting histology in malignant salivary gland tumors: methodology and “proof of principle”

Khodabakhshi,

Motisi,

Bink

et al. 2024

Sci Rep

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Defining the exact histological features of salivary gland malignancies before treatment remains an unsolved problem that compromises the ability to tailor further therapeutic steps individually. Radiomics, a new methodology to extract quantitative information from medical images, could contribute to characterizing the individual cancer phenotype already before treatment in a fast and non-invasive way. Consequently, the standardization and implementation of radiomic analysis in the clinical routine work to predict histology of salivary gland cancer (SGC) could also provide improvements in clinical decision-making. In this study, we aimed to investigate the potential of radiomic features as imaging biomarker to distinguish between high grade and low-grade salivary gland malignancies. We have also investigated the effect of image and feature level harmonization on the performance of radiomic models. For this study, our dual center cohort consisted of 126 patients, with histologically proven SGC, who underwent curative-intent treatment in two tertiary oncology centers. We extracted and analyzed the radiomics features of 120 pre-therapeutic MRI images with gadolinium (T1 sequences), and correlated those with the definitive post-operative histology. In our study the best radiomic model achieved average AUC of 0.66 and balanced accuracy of 0.63. According to the results, there is significant difference between the performance of models based on MRI intensity normalized images + harmonized features and other models (p value < 0.05) which indicates that in case of dealing with heterogeneous dataset, applying the harmonization methods is beneficial. Among radiomic features minimum intensity from first order, and gray level-variance from texture category were frequently selected during multivariate analysis which indicate the potential of these features as being used as imaging biomarker. The present bicentric study presents for the first time the feasibility of implementing MR-based, handcrafted radiomics, based on T1 contrast-enhanced sequences and the ComBat harmonization method in an effort to predict the formal grading of salivary gland carcinoma with satisfactory performance.

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High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases

Freitag

Lettmaier

Semrau

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Salivary Gland cancer (SGC) is a rare and heterogenous group of tumors. Standard therapeutic options achieve high local but poor distant control rates, especially in high-grade SGC. The aim of this monocentric study was to evaluate patterns of recurrence and its treatment options (local ablative vs. systemic) in a homogenously treated patient population with high-grade SGC after surgery and radio(chemo)therapy. Methods Monocentric, retrospective study of patients with newly diagnosed high-grade salivary gland cancer. We retrospectively reviewed clinical reports from 69 patients with high-grade salivary gland cancer in a single-center audit. Survival rates were calculated using the Kaplan–Meier method and prognostic variables were analyzed (univariate analysis: log-rank test; multivariate analysis: Cox regression analysis). Results The median time of follow-up was 31 months. After 5 years, the cumulative overall survival was 65.2%, cumulative incidence of local recurrence was 7.2%, whereas the cumulative incidence of distant metastases was 43.5% after 5 years. 30 of 69 patients developed distant metastases during the time of follow-up, especially patients with adenoid cystic carcinoma, salivary duct carcinoma, adenocarcinoma NOS and acinic cell carcinoma with high-grade transformation. The most common type of therapy therefore was chemotherapy (50%). 85.7% of patients with local ablative therapy of distant metastases show disease progression during follow-up afterwards. Conclusion With surgery and radio-chemotherapy, a high rate of loco-regional control is reached, but over 40% of patients develop distant metastases in the further follow-up which usually present a diffuse pattern involving in a diffuse metastases. Therefore, in the future, intensified interdisciplinary combination therapies even in the first-line treatment in certain subtypes of high-grade SGC should be investigated.

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Patterns of care, toxicity and outcome in the treatment of salivary gland carcinomas: long-term experience from a tertiary cancer center

Cited by 6 publications

References 47 publications

Combined Treatment of Salivary Gland Cancer Patients with the Use of High-Let Radiation

Combined Treatment of Salivary Gland Cancer Patients with the Use of High-Let Radiation

MRI-based radiomics for predicting histology in malignant salivary gland tumors: methodology and “proof of principle”

High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases

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