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

Head Neck. 2019 Jul;41(7):2182-2189. doi: 10.1002/hed.25685. Epub 2019 Feb 5.

Abstract

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.

Results: Median time from diagnosis to primary treatment was 42 days (IQR, 32-54). Median time from surgery to adjuvant therapy was 33 days (IQR, 28-47). Delay in starting treatment was observed in 7/49 patients (14%). Six patients incurred a delay in postoperative radiation therapy (6/19; 32%).

Conclusions: With appropriate care coordination, SMGT can be implemented into a clinical pathway with a goal of decreasing radiation-induced xerostomia without increasing treatment delays.

Keywords: head and neck cancer; radiation; salivary gland; submandibular gland transfer; xerostomia.

Publication types

  • Multicenter Study

MeSH terms

  • Contraindications, Procedure
  • Feasibility Studies
  • Female
  • Head and Neck Neoplasms / therapy
  • Humans
  • Male
  • Middle Aged
  • Organ Sparing Treatments*
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant / adverse effects*
  • Retrospective Studies
  • Submandibular Gland / surgery*
  • Xerostomia / prevention & control*