Chemoreirradiation for recurrent salivary gland malignancies

Pederson, Aaron W.; Haraf, Daniel J.; Blair, Elizabeth A.; Stenson, Kerstin M.; Witt, Mary-Ellyn; Vokes, Everett E.; Salama, Joseph K.

doi:10.1016/j.radonc.2010.03.006

« Previous Next »Radiotherapy & Oncology
Volume 95, Issue 3 , Pages 308-311, June 2010

Chemoreirradiation for recurrent salivary gland malignancies

Aaron W. Pederson
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
Daniel J. Haraf
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
- Cancer Research Center, University of Chicago, Chicago, IL, USA
Elizabeth A. Blair
- Cancer Research Center, University of Chicago, Chicago, IL, USA
- Section of Otolaryngology/Head and Neck Surgery, University of Chicago, Chicago, IL, USA
Kerstin M. Stenson
- Cancer Research Center, University of Chicago, Chicago, IL, USA
- Section of Otolaryngology/Head and Neck Surgery, University of Chicago, Chicago, IL, USA
Mary-Ellyn Witt
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
Everett E. Vokes
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
- Cancer Research Center, University of Chicago, Chicago, IL, USA
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
Joseph K. Salama
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
- Cancer Research Center, University of Chicago, Chicago, IL, USA
- Ludwig Center of Metastases, University of Chicago, Chicago, IL, USA
- Corresponding author at: Department of Radiation and Cellular Oncology, University of Chicago, 5758 S. Maryland Ave., MC 9006, Chicago, IL 60637, USA.

Received 8 June 2009; received in revised form 23 February 2010; accepted 7 March 2010. published online 12 April 2010.

Abstract

Background and purpose

To report our experience in treating recurrent salivary gland malignancies using concurrent chemotherapy and reirradiation.

Materials and methods

Between 1986 and 2007, 14 patients with locoregionally recurrent salivary gland cancer underwent maximal surgical resection followed by adjuvant 5-fluorouracil and hydroxyurea-based chemotherapy concurrently with 1.5Gy twice daily or 2Gy daily reirradiation. Each cycle consisted of chemoreirradiation for 5 consecutive days followed by a 9-day break. The median reirradiation dose was 66Gy (R 30–72Gy) after a mean radiation treatment interval of 48months.

Results

The median follow-up for all patients was 18months (R 2–125months) and 41months for survivors. The parotid gland (n=6) and minor salivary glands (n=6) were involved more commonly than the submandibular gland (n=2). Locoregional control at 1 and 3years was 72.2% and 51.6%, respectively. Actuarial overall survival at 3 and 5years was 35.7% and 26.8%, respectively. Tracheostomies and feeding tubes were placed in 2 and 8 patients, respectively. Six patients had feeding tubes at last follow-up or death.

Conclusions

Concurrent chemotherapy and reirradiation for recurrent salivary malignancies result in promising locoregional control for patients with recurrent salivary gland malignancies.

Keywords: Salivary malignancy, Reirradiation, Chemoradiotherapy, Head and neck cancer