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Recurrent salivary gland carcinomas treated by surgery with or without intraoperative radiation therapy
Author(s) -
Chen Allen M.,
Garcia Joaquin,
Bucci M. Kara,
Chan Albert S.,
Kaplan Michael J.,
Singer Mark I.,
Phillips Theodore L.
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20651
Subject(s) - medicine , salivary gland , salvage surgery , surgery , radiation therapy , salvage therapy , salivary gland cancer , distant metastasis , head and neck , metastasis , cancer , chemotherapy
Abstract Background. The optimal treatment for patients with locally recurrent carcinomas of the salivary glands is unclear. Methods. Ninety‐nine patients underwent salvage surgery for locally recurrent salivary gland carcinomas. Eighty‐one (82%) had previously received radiation. Thirty‐seven patients (37%) received intraoperative radiation therapy (IORT) to a median dose of 15 Gy (range, 12–18 Gy) at the time of salvage. Results. The 1‐, 3‐, and 5‐year estimates of local control after salvage surgery were 88%, 75%, and 69%, respectively. A Cox proportional hazard model identified positive margins (0.01) and the omission of IORT ( p = .001) as independent predictors of local failure. The 5‐year overall survival was 34%. Distant metastasis was the most common site of subsequent failure, occurring in 42% of patients. Conclusions. IORT significantly improves disease control for patients with locally recurrent carcinomas of the salivary glands. The high rate of distant metastasis emphasizes the need for effective systemic therapies. © 2007 Wiley Periodicals, Inc. Head Neck, 2008