Adjuvant chemoradiotherapy for locoregionally advanced and high-risk salivary gland malignancies

Aaron W. Pederson, Joseph K. Salama, Daniel J. Haraf, Mary Ellen Witt, Kerstin M. Stenson, Louis Portugal, Tanguy Lim Seiwert, Victoria M. Villaflor, Ezra E.W. Cohen, Everett E. Vokes, Elizabeth A. Blair

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Abstract

Background: To report the outcomes of patients with locoregionally advanced and high- risk salivary gland malignancies treated with surgery followed by adjuvant chemoradiotherapy. Methods. From 09/1991 - 06/2007, 24 high-risk salivary gland cancer patients were treated with surgery, followed by adjuvant chemoradiotherapy for high-risk pathologic features including, perineural involvement, nodal involvement, positive margins, or T3/T4 tumors. Chemoradiotherapy was delivered for 4-6 alternating week cycles: the most common regimen, TFHX, consisted of 5 days paclitaxel (100 mg/m2 on d1), infusional 5-fluorouracil (600 mg/m2/d × 5d), hydroxyurea (500 mg PO BID), and 1.5 Gy twice daily irradiation followed by a 9-day break without treatment. Results: Median follow-up was 42 months. The parotid gland was more frequently involved (n = 17) than minor (n = 4) or submandibular (n = 3) glands. The median radiation dose was 65 Gy (range 55-68 Gy). Acute treatment related toxicity included 46% grade 3 mucositis and 33% grade 3 hematologic toxicity. Six patients required feeding tubes during treatment. One patient progressed locally, 8 patients progressed distantly, and none progressed regionally. Five-year locoregional progression free survival was 96%. The 3 and 5 year overall survival was 79% and 59%, respectively. Long-term complications included persistent xerostomia (n = 5), esophageal stricture requiring dilatation (n = 1), and tempromandibular joint syndrome (n = 1). Conclusions: Surgical resection followed by adjuvant chemoradiotherapy results in promising locoregional control for high-risk salivary malignancy patients.

Original languageEnglish (US)
Article number31
JournalHead and Neck Oncology
Volume3
Issue number1
DOIs
StatePublished - Jul 28 2011
Externally publishedYes

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ASJC Scopus subject areas

  • Otorhinolaryngology
  • Oncology

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Pederson, A. W., Salama, J. K., Haraf, D. J., Witt, M. E., Stenson, K. M., Portugal, L., Lim Seiwert, T., Villaflor, V. M., Cohen, E. E. W., Vokes, E. E., & Blair, E. A. (2011). Adjuvant chemoradiotherapy for locoregionally advanced and high-risk salivary gland malignancies. Head and Neck Oncology, 3(1), [31]. https://doi.org/10.1186/1758-3284-3-31