(P085) Oncologic and Functional Outcomes of Salivary Gland Tumors (SGTs) With Pathologically Proven Perineural Invasion (PNI)

OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

A multimodality approach to SGTs with PNI provides excellent LRC. Further studies are warranted to identify the patients at higher risk of LRF and DMs to optimize their management.

Bryan M. Rabatic, PhD, MD, David Zaenger, MD, Joseph M. Kaminski, MD, Waleed F. Mourad, MD, PhD; Georgia Regents University

PURPOSE: To report the clinical outcomes and patterns of failure of salivary gland tumors (SGTs) with perineural invasion (PNI) status postmultimodality approach (ie, surgery, postoperative radiation therapy [RT], and chemotherapy).

MATERIALS: This is a single-institution retrospective study that was fully approved by our institutional review board (IRB). From March 1997–2010, a total of 62 patients with SGTs underwent the multimodality approach due to the presence of PNI ± other high-risk features (recurrent tumor, R1 or R2 resection, positive margins, multiple positive lymph nodes, and extracapsular extension). Intensity-modulated RT (IMRT) was utilized in 50% of the patients. RT fields included the tumor bed, ipsilateral neck, and occasionally the contralateral neck. The most common pathologically involved nerves (facial, V2, and V3) were included in the RT fields to the skull base. The median RT dose delivered was 63 Gy (range: 50–70 Gy at 1.8–2 Gy/fraction). A total of 53%, 34%, and 13% of cases were parotid, minor salivary, and submandibular gland primaries, respectively. Pathologically adenoid cystic carcinoma and adenocarcinoma were the most common histologies (39% and 24%, respectively).

RESULTS: The median age was 53 years (range: 20–78 yr). Males and Caucasians made up 50% and 50% of the population, respectively. With a median follow-up of 5 years (range: 1–10 yr), the 5-year actuarial disease-free survival (DFS), locoregional control (LRC), and distant control (DC) rates were 85%, 94%, and 91%, respectively. The median time to LR failure (LRF) and distant metastases (DMs) was 8 months (range: 6–16 mo) and 30 months (range: 18–60 mo), respectively. Late RT toxicity was grade ≤ 2 xerostomia (20%), altered taste (15%), trismus (6%), dysphagia (4%), and neck stiffness (2%).

CONCLUSIONS: A multimodality approach to SGTs with PNI provides excellent LRC. Further studies are warranted to identify the patients at higher risk of LRF and DMs to optimize their management.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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