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Salivary Gland Tumors: Radiotherapy

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Salivary Gland Cancer

Abstract

Salivary gland tumors (SGTs) are rare diseases, and their treatment depends on histology, stage, primary site, and location within the gland.

Radical surgery is the mainstay of treatment, but radiotherapy (RT) plays a key role in both postoperative and unresectable, as well as in recurrent disease.

In the absence of prospective randomized trials for high-risk SGTs, a wide retrospective literature reports that postoperative RT (PORT) allows improved local control rates compared with surgical resection alone, even if the benefit on overall survival is poorly described.

Photon is the most common and widely used type of radiation, and it is available at most cancer centers. The last two decades has seen significant technological advances for photon RT in terms of more precise dose delivery by using intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic radiotherapy (SBRT). SGTs are excellent candidates to receive IMRT and VMAT due to the frequency of horseshoe-shaped target volumes (e.g., in case of perineural invasion) and their proximity to radiosensitive normal structures (e.g., tumors arising from minor salivary glands in paranasal sinuses).

The following chapter will provide an overview of the role and the impact of photon RT for adenoid cystic carcinoma (ACC), non-ACC high-grade and low-grade carcinomas, as well as pleomorphic adenoma. Postoperative, definitive, reirradiation, and combined RT settings will be discussed. Different histologies have been taken into consideration also in terms of RT dose and target volumes.

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Abbreviations

3DRT:

3-dimensional conformal radiation therapy

ACC:

Adenoid cystic carcinoma

AciCC:

Acinic cell carcinoma

CRT:

Chemoradiotherapy

CT:

Chemotherapy

CXPA:

Ex pleomorphic adenoma

DFS:

Disease-free survival

DSS:

Disease-specific survival

ECE:

Extracapsular extension

END:

Elective neck dissection

ENI:

Elective neck irradiation

HG:

High grade

IG:

Intermediate grade

IMRT:

Intensity-modulated radiation therapy

LC:

Local control

LF:

Local failure

LG:

Low grade

LGSGTs:

Low-grade salivary glands cancers

LRC:

Locoregional control

MEC:

Mucoepidermoid carcinoma

OS:

Overall survival

PLGA:

Polymorphous low-grade adenocarcinoma

PNI:

Perineural involvement

PORT:

Postoperative radiation therapy

RFS:

Recurrence-free survival

RT:

Radiotherapy

SBRT:

Stereotactic radiotherapy

SEER:

Surveillance, epidemiology, and end results

SGTs:

Salivary gland tumors

SOR:

Standards, options, and recommendations

VMAT:

Volumetric modulated arc therapy

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Orlandi, E., Sanguineti, G., Fallai, C. (2019). Salivary Gland Tumors: Radiotherapy. In: Licitra, L., Locati, L. (eds) Salivary Gland Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-02958-6_11

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