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. 2014 Jan 22;48(1):56-61.
doi: 10.2478/raon-2013-0046. eCollection 2014 Mar.

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

Daniel E Spratt  1 , Lucas Resende Salgado  1 , Nadeem Riaz  1 , Michael G Doran  1 , Moses Tam  1 , Suzanne Wolden  1 , Evangelia Katsoulakis  1 , Shyam Rao  1 , Alan Ho  2 , Richard Wong  3 , Nancy Y Lee  1
Affiliations

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

Daniel E Spratt et al. Radiol Oncol. .

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: IMRT; neutron; photon; radiotherapy; salivary gland cancer.

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Figures

FIGURE 1.
FIGURE 1.
Local failure cumulative incidence for entire cohort with death as the competing risk.
FIGURE 2.
FIGURE 2.
Loco-regional failure cumulative incidence for entire cohort with death as the competing risk.
FIGURE 3.
FIGURE 3.
Distant-metastasis cumulative incidence for the entire cohort with death as the competing risk.
FIGURE 4.
FIGURE 4.
Kaplan Meier for overall survival of entire cohort.
See this image and copyright information in PMC

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