Recurrent salivary gland carcinomas treated by surgery with or without intraoperative radiation therapy

Chen, Allen M.; García, Joaquín J.; Bucci, M. Kara; Chan, Albert; Kaplan, Michael; Singer, Mark I.; Phillips, Theodore L.

doi:10.1002/hed.20651

Cited by 22 publications

(26 citation statements)

References 30 publications

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“…Scala et al reported that 1-year in-field control for patients with negative margins was 82% compared to 56% in those with a positive margin (9). At least five other studies also showed that positive margins (more so for gross residual than microscopic residual) at the time of IORT significantly predicted for in-field failure when compared to close or clear margins (2, 11, 13, 18, 19). In addition, doses of IORT of more than 15 Gy were shown to be associated with better LC (10, 12).…”

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 93%

“…The second study included 37 patients with recurrent SGT who received a median dose of 15 Gy IOERT in addition to EBRT (54 Gy) in 15%. LC at 5 years was better with IORT compared to no IORT (82 vs. 60%) and 5-year OS was 34% for the entire sample (2). …”

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 98%

“…Fistula/abscess rate ranged between 4 and 15% (3, 4, 10–12, 14, 18, 27). Wound related toxicity from cellulitis to flap necrosis ranged from 0 to 12% (2–4, 6, 10–12, 14, 27). Osteoradionecrosis rates are reported to range from 0 to 13% (3, 4, 6, 11, 12, 14, 19).…”

Section: Toxicity Of Iortmentioning

confidence: 99%

“…Osteoradionecrosis rates are reported to range from 0 to 13% (3, 4, 6, 11, 12, 14, 19). Furthermore, some studies report on treatment related neuropathy ranging from 1 to 3% and mostly treated by symptomatic pain management (2, 4, 6, 11–13). Of note, higher neuropathy rates were noted in a study from MSKCC reporting the outcomes of 57 patients with recurrent tumors, where neuropathy rates reached 26%, trismus rate of 24%, and fibrosis rate of 29% (10).…”

Section: Toxicity Of Iortmentioning

confidence: 99%

“…Radiation therapy (RT) is commonly used as adjuvant treatment or, as definitive modality when surgical resection is not possible. Delivering radiation at the time of resection of HNCs is particularly helpful in cases at high risk for recurrence, particularly where there is gross or microscopic residual disease or for recurrent disease (2). The safety and effectiveness of intraoperative radiation therapy (IORT) for HNCs have been established in studies from several institutions (3–5).…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

et al. 2017

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Every year, almost 62,000 are diagnosed with a head and neck cancer (HNC) and 13,000 will succumb to their disease. In the primary setting, intraoperative radiation therapy (IORT) can be used as a boost in select patients in order to optimize local control. Addition of external beam radiation to limited volumes results in improved disease control over surgery and IORT alone. In the recurrent setting, IORT can improve outcomes from salvage surgery especially in patients previously treated with external beam radiation. The use of IORT remains limited to select institutions with various modalities being currently employed including orthovoltage, electrons, and high-dose rate brachytherapy. Practically, execution of IORT requires a coordinated effort and careful planning by a multidisciplinary team involving the head and neck surgeon, radiation oncologist, and physicist. The current review summarizes common uses, outcomes, toxicities, and technical aspects of IORT in HNC patients.

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Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 93%

Section: Role Of Iort In Head and Neck Tumorsmentioning

confidence: 98%

Section: Toxicity Of Iortmentioning

confidence: 99%

Section: Toxicity Of Iortmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

et al. 2017

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Recent trends in the management of minor salivary gland carcinoma

et al. 2013

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The current management of minor salivary gland cancer is reviewed. These malignancies often present as a submucosal swelling and have been reported at all anatomic subsites of the head and neck. Modern imaging is essential in evaluating the location and the anatomic extent of disease. An incisional or punch biopsy determines the histologic type and grade. Recent advances in molecular biology have yielded diagnostic and potential therapeutic targets that may change our treatment in the future. Complete resection is the treatment of choice. Unfortunately, given the proximity of essential structures, the need to balance functional and cosmetic with oncologic consequences can interfere with an adequate "clear margin." The neck should be treated when there is evidence of regional metastasis or when subclinical metastatic risk exceeds 15%. Surgery alone cures most low-stage, low-grade tumors, all other stages and grades require postoperative radiotherapy. Systemic treatment for locoregional and distant failure remains disappointing.

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Recurrence after primary salivary gland carcinoma: Frequency, survival, and risk factors

Nachtsheim,

Jansen,

Shabli

et al. 2024

Head & Neck

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BackgroundPrimary salivary gland carcinomas (SGC) are rare neoplasms that present therapeutic challenges especially in recurrent tumors. The aim of this study was to investigate the incidence and distribution of tumor recurrence, associated risk factors, and survival.MethodsThis analysis includes data from 318 patients treated for SGC between 1992 and 2020. Survival analysis was performed using the Kaplan–Meier method. Univariate and multivariate analyses were used to identify risk factors associated with recurrence.Results21.7% of the patients developed recurrent disease after a mean of 38.2 months. In multivariate analysis, positive‐resection margins, vascular invasion, and tumor localization in the submandibular gland and small salivary glands were independent factors for recurrence. The 5‐year overall survival was 67%, the 5‐year disease‐free survival was 54%.ConclusionTumor recurrence in SGC occurred in one out of five patients. In highly aggressive entities and patients with risk factors, treatment intensification should be considered.

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Recurrent salivary gland carcinomas treated by surgery with or without intraoperative radiation therapy

Cited by 22 publications

References 30 publications

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

Recent trends in the management of minor salivary gland carcinoma

Recurrence after primary salivary gland carcinoma: Frequency, survival, and risk factors

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