Bing-Shen Huang1, Wan-Yu Chen2, Cheng-En Hsieh3, Chien-Yu Lin3, Li-Yu Lee4, Ku-Hao Fang5, Ngan-Ming Tsang3, Chung-Jan Kang6, Hung-Ming Wang7, Joseph Tung-Chieh Chang8. 1. Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan. 2. Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei Cancer Research Center, National Taiwan University College of Medicine, Taipei Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei. 3. Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan. 4. Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan Department of Pathology, Chang Gung Memorial Hospital, Taoyuan. 5. Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Taoyuan. 6. Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Taoyuan. 7. Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan. 8. Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan Head and Neck Oncology Group, Chang Gung Memorial Hospital, Taoyuan jtchang@adm.cgmh.org.tw.
Abstract
OBJECTIVE: To evaluate the outcomes and prognostic factors in patients with parotid gland cancers treated with adjuvant radiotherapy with or without chemotherapy. METHODS: Eighty-five patients with parotid gland cancers were identified between October 2001 and September 2011. The median radiation dose was 66 Gy (range, 9-76 Gy). The outcomes assessment included overall survival, locoregional control, distant metastasis-free survival and disease-free survival. RESULTS: The stage distribution was 20 patients (23.5%) in stage I, 28 (32.9%) stage II, 14 (16.5%) stage III and 23 (27.1%) stage IV. Fifty-five patients (64.7%) had positive margins and 23 patients (27.1%) had close margins (<0.5 cm). Lymph node extracapsular spreading occurred in nine patients. The adjuvant therapy included radiotherapy alone in 47 patients (55.3%) and concurrent chemoradiotherapy in 38 patients (44.7%). With a median follow-up of 4.5 years (range, 0.4-11 years), the 5-year overall survival, locoregional control, distant metastasis-free survival and disease-free survival were 82.0, 88.4, 82.4 and 77.5%, respectively. Based on multivariate analysis, N1/N2 was a significant negative prognostic factor for distant metastasis-free survival, disease-free survival and overall survival. Perineural invasion was a significant negative prognostic factor for locoregional control, distant metastasis-free survival and disease-free survival. Patients 50 years or older had significantly worse distant metastasis-free survival, disease-free survival and overall survival. CONCLUSIONS: Surgery and radiotherapy treatment could achieve excellent outcomes in a modern cohort. However, N1/N2, perineural invasion and age ≥50 years, but not positive margins, are significant factors associated with a worse prognosis.
OBJECTIVE: To evaluate the outcomes and prognostic factors in patients with parotid gland cancers treated with adjuvant radiotherapy with or without chemotherapy. METHODS: Eighty-five patients with parotid gland cancers were identified between October 2001 and September 2011. The median radiation dose was 66 Gy (range, 9-76 Gy). The outcomes assessment included overall survival, locoregional control, distant metastasis-free survival and disease-free survival. RESULTS: The stage distribution was 20 patients (23.5%) in stage I, 28 (32.9%) stage II, 14 (16.5%) stage III and 23 (27.1%) stage IV. Fifty-five patients (64.7%) had positive margins and 23 patients (27.1%) had close margins (<0.5 cm). Lymph node extracapsular spreading occurred in nine patients. The adjuvant therapy included radiotherapy alone in 47 patients (55.3%) and concurrent chemoradiotherapy in 38 patients (44.7%). With a median follow-up of 4.5 years (range, 0.4-11 years), the 5-year overall survival, locoregional control, distant metastasis-free survival and disease-free survival were 82.0, 88.4, 82.4 and 77.5%, respectively. Based on multivariate analysis, N1/N2 was a significant negative prognostic factor for distant metastasis-free survival, disease-free survival and overall survival. Perineural invasion was a significant negative prognostic factor for locoregional control, distant metastasis-free survival and disease-free survival. Patients 50 years or older had significantly worse distant metastasis-free survival, disease-free survival and overall survival. CONCLUSIONS: Surgery and radiotherapy treatment could achieve excellent outcomes in a modern cohort. However, N1/N2, perineural invasion and age ≥50 years, but not positive margins, are significant factors associated with a worse prognosis.
Authors: Mateusz Szewczyk; Paweł Golusiński; Jakub Pazdrowski; Piotr Pieńkowski; Sławomir Marszałek; Jacek Sygut; Wojciech Golusiński Journal: Rep Pract Oncol Radiother Date: 2018-06-23