Minor salivary gland tumors: the role of radiotherapy.

Previous analyses of minor salivary gland tumors (MSGTs) have not clearly established the role of radiotherapy in their treatment. The following is a retrospective review of 44 patients treated from 1956 to 1984 with MSGT of the maxillary sinus (15 of 44), nasal cavity/ethmoid complex (six of 44), or hard palate (23 of 44). Histological findings included adenocarcinoma (18), adenoid cystic (17), high-grade mucoepidermoid (six), and mixed malignant (three). Treatment was by surgery (18 of 44), radiotherapy (eight of 44), or a combination of both (18 of 44). Patients treated with radiotherapy, either alone or combined with surgery, had disease that was inoperable, marginally resectable, or residual after surgery. Despite this handicap, 3-year local control rates for all treatment modalities were similar (surgery, 78%; radiotherapy, 63%; and combined treatment, 83%). Absolute 3-year survival rates were 94% for surgery, 63% for radiotherapy, and 78% for combined therapy, with death attributable to distant metastases a significant factor in the advanced cases treated with radiotherapy. A dose response relationship was apparent in those patients whose treatment involved radiotherapy. Clearly, MSGTs are radioresponsive lesions and radiotherapy can play an important role in their management.