Results of photon radiotherapy for unresectable salivary gland tumors: Is neutron radiotherapy's local control superior? Journal Article


Authors: Spratt, D. E.; Salgado, L. R.; Riaz, N.; Doran, M. G.; Tam, M.; Wolden, S.; Katsoulakis, E.; Rao, S.; Ho, A.; Wong, R.; Lee, N. Y.
Article Title: Results of photon radiotherapy for unresectable salivary gland tumors: Is neutron radiotherapy's local control superior?
Abstract: Background. The results of RTOG-MRC randomized trial of photon (n=15) versus neutron (n=17) therapy in the 1980's reported an improved local control (LC) with neutron radiotherapy for unresectable salivary gland tumors. Due to increased severe toxicity with neutron radiotherapy and the paucity of neutron-therapy centers, we analyzed our institution's results of photon radiotherapy for unresectable salivary gland tumors. Patients and methods. From 1990 to 2009, 27 patients with unresectable salivary gland cancer underwent definitive photon radiotherapy at our institution. Nodal involvement on presentation was found in 9 patients. Median dose of radiotherapy was 70 Gy. Chemotherapy was given to 18 patients, most being platinum-based regimens. Local control (LC), locoregional control (LRC), distant metastasis-free survival (DMFS), overall survival (OS), and toxicity outcomes were assessed. Results. With a median follow-up of 52.4 months, the 2/5-year actuarial LC was 69% (95% CI +/- 21.0%)/55% (+/- 24.2%), LRC was 65% (+/- 21.4%)/47% (+/- 21.6%), and DMFS was 71% (+/- 21.8%)/51% (+/- 22.8%), respectively using competing risk analysis. The median OS was 25.7 months, and the 2/5-year OS rates were 50% (+/- 19.0%)/29% (+/- 16.6%), respectively. Higher histologic grade was significant for an increased rate of DM (intermediate grade vs. low grade, p=0.04, HR 7.93; high grade vs. low grade, p=0.01, HR 13.50). Thirteen (48%) patient's experienced acute grade 3 toxicity. Late grade 3 toxicity occurred in three (11%) patients. Conclusions. Our data compares favorably to neutron radiotherapy with fewer late complications. Photon radiotherapy is an acceptable alternative to neutron radiotherapy in patients who present with unresectable salivary gland tumors.
Keywords: radiotherapy; imrt; irradiation; salivary gland cancer; photon; radiation-therapy; concurrent chemoradiotherapy; neutron; adenoid-cystic carcinoma
Journal Title: Radiology and Oncology
Volume: 48
Issue: 1
ISSN: 1318-2099
Publisher: Assoc Radiology & Oncology  
Date Published: 2014-01-22
Start Page: 56
End Page: 61
Language: English
ACCESSION: WOS:000330179900008
DOI: 10.2478/raon-2013-0046
PROVIDER: Thomson Reuters Web of Scienceā„¢
PROVIDER: wos
PMCID: PMC3908848
PUBMED: 24587780
Notes: Article -- Source: Wos
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MSK Authors
  1. Suzanne L Wolden
    560 Wolden
  2. Nadeem Riaz
    418 Riaz
  3. Nancy Y. Lee
    877 Lee
  4. Richard J Wong
    416 Wong
  5. Shyam S Rao
    83 Rao
  6. Alan Loh Ho
    240 Ho
  7. Daniel Eidelberg Spratt
    77 Spratt
  8. Michael G. Doran
    17 Doran
  9. Moses Min-Chi Tam
    9 Tam