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Title: The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland

Abstract

Purpose: To evaluate the impact of postoperative radiation therapy on the clinical course of patients with carcinoma ex pleomorphic adenoma of the parotid gland. Methods and Materials: Between 1960 and 2004, 63 patients were treated with definitive surgery for carcinoma ex pleomorphic adenoma of the parotid gland. Forty patients (63%) received postoperative radiation therapy to a median dose of 60 Gy (range, 45-71 Gy). Adenocarcinoma (29 patients), salivary duct carcinoma (16 patients), and adenoid cystic carcinoma (9 patients) were the most common malignant subtypes. Pathologic T -stage was: 16% T1, 33% T2, 32% T3, and 19% T4. Twenty-one patients (33%) had microscopically positive margins and 39 (62%) had perineural invasion. Median follow-up was 50 months (range, 2-96 months). Results: The use of postoperative therapy significantly improved 5-year local control from 49% to 75% (p = 0.005) and was associated with an improvement in survival among patients without evidence of cervical lymph node metastasis (p = 0.01). A Cox proportional hazard model identified pathologic involvement of cervical lymph nodes as an independent predictor of overall survival. Overall survival was 16% for patients with pathologic N-positive disease compared with 67% for those whose lymph node status was negative or unknown (p =more » 0.001). Conclusion: Surgery followed by postoperative radiation should be considered the standard of care for patients with carcinoma ex pleomorphic adenoma.« less

Authors:
 [1];  [2];  [3];  [3];  [4]
  1. Department of Radiation Oncology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States). E-mail: allenmchen@yahoo.com
  2. Department of Pathology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)
  3. Department of Radiation Oncology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)
  4. Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA (United States)
Publication Date:
OSTI Identifier:
20850306
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.07.1380; PII: S0360-3016(06)02747-7; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADENOMAS; GLANDS; HEALTH HAZARDS; LYMPH NODES; METASTASES; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SURGERY

Citation Formats

Chen, Allen M., Garcia, Joaquin, Bucci, M. Kara, Quivey, Jeanne M., and Eisele, David W. The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.07.1380.
Chen, Allen M., Garcia, Joaquin, Bucci, M. Kara, Quivey, Jeanne M., & Eisele, David W. The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland. United States. doi:10.1016/j.ijrobp.2006.07.1380.
Chen, Allen M., Garcia, Joaquin, Bucci, M. Kara, Quivey, Jeanne M., and Eisele, David W. Mon . "The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland". United States. doi:10.1016/j.ijrobp.2006.07.1380.
@article{osti_20850306,
title = {The role of postoperative radiation therapy in carcinoma ex pleomorphic adenoma of the parotid gland},
author = {Chen, Allen M. and Garcia, Joaquin and Bucci, M. Kara and Quivey, Jeanne M. and Eisele, David W.},
abstractNote = {Purpose: To evaluate the impact of postoperative radiation therapy on the clinical course of patients with carcinoma ex pleomorphic adenoma of the parotid gland. Methods and Materials: Between 1960 and 2004, 63 patients were treated with definitive surgery for carcinoma ex pleomorphic adenoma of the parotid gland. Forty patients (63%) received postoperative radiation therapy to a median dose of 60 Gy (range, 45-71 Gy). Adenocarcinoma (29 patients), salivary duct carcinoma (16 patients), and adenoid cystic carcinoma (9 patients) were the most common malignant subtypes. Pathologic T -stage was: 16% T1, 33% T2, 32% T3, and 19% T4. Twenty-one patients (33%) had microscopically positive margins and 39 (62%) had perineural invasion. Median follow-up was 50 months (range, 2-96 months). Results: The use of postoperative therapy significantly improved 5-year local control from 49% to 75% (p = 0.005) and was associated with an improvement in survival among patients without evidence of cervical lymph node metastasis (p = 0.01). A Cox proportional hazard model identified pathologic involvement of cervical lymph nodes as an independent predictor of overall survival. Overall survival was 16% for patients with pathologic N-positive disease compared with 67% for those whose lymph node status was negative or unknown (p = 0.001). Conclusion: Surgery followed by postoperative radiation should be considered the standard of care for patients with carcinoma ex pleomorphic adenoma.},
doi = {10.1016/j.ijrobp.2006.07.1380},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 67,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 2007},
month = {Mon Jan 01 00:00:00 EST 2007}
}