Survival and quality of life in oropharyngeal cancer patients treated with primary chemoradiation after salivary gland transfer

Morand, G; Madana, J.; Silva, S D Da; Roskies, Michael; Sultanem, Khalil; Black, Martin J.; Mlynarek, Alex; Hier, Michael P.

doi:10.1017/s0022215116008100

Cited by 11 publications

(10 citation statements)

References 30 publications

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“…Median time to primary treatment (surgical or nonsurgical) in our cohort was 42 days overall (32 days in primary surgery group, 46.5 days in nonsurgical group). Notably, the median time to treatment in our cohort was 26 days faster than that reported in another SMGT cohort by Morand et al 22 Graboyes et al examined over 40 000 patients in the NCDB with HNC undergoing postoperative RT from 2006 to 2014, and found that administration of adjuvant RT >6 weeks after surgery was associated with 10% worse overall 5-year survival. 27 Delay in administration of adjuvant radiation occurred in 55% of cases reported by Graboyes et al By comparison, 32% of our surgical patients (6/19) had a delay in adjuvant radiation start time more than 6 weeks after surgery, a relative improvement of 31%.…”

Section: Discussioncontrasting

confidence: 46%

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Implementation of submandibular gland transfer: A multi‐institutional study of feasibility and time to treatment

et al. 2019

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Background: Submandibular gland transfer (SMGT) mitigates radiation-induced xerostomia but has yet to be widely adopted. We evaluate the feasibility of incorporating SMGT at multiple academic institutions and report the incidence of treatment delay. Methods: Forty-nine patients were identified who underwent SMGT. Time points pertaining to diagnosis and key treatment events including SMGT, surgery, chemotherapy, and radiation were extracted. Treatment delay was defined as either >60 days from diagnosis to definitive therapy or >6 weeks between surgery and adjuvant therapy.

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Section: Discussioncontrasting

confidence: 46%

“…21 SMGT results in significantly better xerostomia scores compared with IMRT as well. 22 A systematic review and meta-analysis concluded that, overall, SMGT prevents xerostomia in 83% of patients. 23 Oncologic outcomes are available for a small number of patients.…”

Section: Introductionmentioning

confidence: 99%

Implementation of submandibular gland transfer: A multi‐institutional study of feasibility and time to treatment

et al. 2019

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“…10,[26][27][28][29][30] However, with the aid of SMG-T, previous reports have shown that mean radiation doses from 23 to 30.86 Gy could routinely be achieved, and reports of moderate to severe xerostomia were low, between 11% and 31.6% (Table 4). [31][32][33] Oncologic safety must be maintained as a priority during these procedures. When patients undergo SMG-T, the specimen should be sent for pathologic analysis to make sure that there are not neck micrometastasis in level Ia and contralateral level Ib which are scheduled for sparing from subsequent IMRT.…”

Section: Discussionmentioning

confidence: 99%

Modified technique of submandibular gland transfer followed by intensity modulated radiotherapy to reduce xerostomia in head and neck cancer patients

et al. 2020

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Background Xerostomia is one of the most common long‐term adverse effects of radiotherapy for head and neck cancer patients. Contralateral submandibular gland transfer (SMG‐T) before radiotherapy was shown to reduce xerostomia compared to pilocarpine. We sought to evaluate a modification of this surgery preserving the ipsilateral facial artery and vein to simplify the SMG‐T. Methods Eighteen patients planned for head and neck intensity modulated radiotherapy to both necks were reviewed. Surgical complications were recorded. The grade of xerostomia was assessed after treatment completion. Results There were no minor or major complications resulting from the modified SMG‐T. At 24.5‐months follow up, the incidence of post‐treatment moderate to severe xerostomia was 16.7%. No locoregional recurrence occurred. Only one patient had distant solitary lung metastasis. Conclusion The modified SMG‐T technique is a practical and effective method to reduce the dose of radiation to the contralateral SMG and limit post‐treatment xerostomia.

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“…With the intensification of nonoperative treatment approaches, an increasing number of patients are experiencing long-term swallowing impairments and functional deficiencies 38 . These late toxic effects are more common following primary chemoradiation in comparison to upfront surgery with postoperative radiotherapy 38,39 . Tschiesner et al .…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Pretherapeutic Maximum Standardized Uptake Value (Suvmax) In Laryngeal and Hypopharyngeal Cancer

Werner

Hüllner

Rupp

et al. 2019

Sci Rep

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The aim of the study was to evaluate whether pretherapeutic metabolic tumor parameters from 18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging could predict larynx preservation in laryngeal and hypopharyngeal cancer patients prior to primary chemoradiation. Tumor metabolic parameters [maximum standardized uptake value (SUV max ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were retrospectively assessed in a consecutive cohort of laryngeal and hypopharyngeal cancer patients undergoing primary (chemo-)radiation. Main outcome measures were larynx preservation and survival. The study included 97 patients with a median follow-up of 32 months (IQR 20–54.5). For hypopharyngeal cancer, multivariable analysis showed that patients with a primary tumor’s SUV max > 9.5 entailed a higher risk of undergoing salvage pharyngolaryngectomy after chemoradiation (HR = 8.64, 95% CI = 1.1–67.3, P = 0.040). In laryngeal cancer, SUV max did not predict the need for salvage laryngectomy. The only predictor for larynx preservation in laryngeal cancer patients was T-classification at initial diagnosis (HR = 6.67, 95% CI = 0.82–53.9, P = 0.039). In conclusion, SUV max of primary tumor could be used as a predictor of larynx preservation prior to primary chemoradiation in hypopharyngeal cancer patients. This information may be important for patient counseling, as high SUV max was correlated with reduced probability of larynx preservation. However, in laryngeal cancer patients, SUV max does not seem to be predictive of outcome.

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Survival and quality of life in oropharyngeal cancer patients treated with primary chemoradiation after salivary gland transfer

Abstract: The treatment delay associated with salivary gland transfer surgery does not negatively affect patient survival. Oropharyngeal squamous cell patients have an excellent quality of life after salivary gland transfer.

Cited by 11 publications

References 30 publications

Implementation of submandibular gland transfer: A multi‐institutional study of feasibility and time to treatment

Implementation of submandibular gland transfer: A multi‐institutional study of feasibility and time to treatment

Modified technique of submandibular gland transfer followed by intensity modulated radiotherapy to reduce xerostomia in head and neck cancer patients

Predictive Value of Pretherapeutic Maximum Standardized Uptake Value (Suvmax) In Laryngeal and Hypopharyngeal Cancer

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