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The protective role of postoperative radiation therapy in low and intermediate grade major salivary gland malignancies: A study of the Canadian Head and Neck Collaborative Research Initiative.
Morand, Grégoire B; Eskander, Antoine; Fu, Rui; de Almeida, John; Goldstein, David; Noroozi, Hesameddin; Hosni, Ali; Seikaly, Hadi; Tabet, Paul; Pyne, Justin M; Matthews, T Wayne; Dort, Joseph; Nakoneshny, Steve; Christopoulos, Apostolos; Bahig, Houda; Johnson-Obaseki, Stephanie; Hua, Nadia; Gaudet, Marc; Jooya, Alborz; Nichols, Anthony; Laxague, Francisco; Cecchini, Matthew; Du, Jenny; Shapiro, Justin; Karam, Irene; Dziegielewski, Peter T; Hanubal, Krishna; Erovic, Boban; Grasl, Stefan; Davies, Joel; Monteiro, Eric; Gete, Maru; Witterick, Ian; Sadeghi, Nader; Richardson, Keith; Shenouda, George; Maniakas, Anastasios; Landry, Vivianne; Gupta, Michael; Zhou, Kelvin; Mlynarek, Alex M; Pusztaszeri, Marc; Sultanem, Khalil; Hier, Michael P.
Afiliação
  • Morand GB; Department of Otolaryngology Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
  • Eskander A; Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
  • Fu R; Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
  • de Almeida J; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Goldstein D; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Noroozi H; Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Hosni A; Department of Radiation Oncology, Princess Margaret Cancer Center-University Health Network, University of Toronto, Toronto, Ontario, Canada.
  • Seikaly H; Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
  • Tabet P; Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
  • Pyne JM; Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
  • Matthews TW; Department Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Dort J; Department Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Nakoneshny S; Department Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta, Canada.
  • Christopoulos A; Department of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montreal (CHUM), Université de Montreal, Montreal, Quebec, Canada.
  • Bahig H; Department of Radiation Oncology, CHUM, Université de Montreal, Montreal, Quebec, Canada.
  • Johnson-Obaseki S; Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
  • Hua N; Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
  • Gaudet M; Department of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
  • Jooya A; Department of Radiation Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
  • Nichols A; Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
  • Laxague F; Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
  • Cecchini M; Department of Otolaryngology-Head and Neck Surgery and Oncology, London Health Sciences Center, London, Ontario, Canada.
  • Du J; Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
  • Shapiro J; Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
  • Karam I; Department of Radiation Oncology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
  • Dziegielewski PT; Department of Otolaryngology-Head and Neck Surgery, University of Florida Health Shands Hospital, University of Florida, Gainesville, Florida, USA.
  • Hanubal K; Department of Otolaryngology-Head and Neck Surgery, University of Florida Health Shands Hospital, University of Florida, Gainesville, Florida, USA.
  • Erovic B; Institute of Head and Neck Diseases, Evangelical Hospital, Vienna, Austria.
  • Grasl S; Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
  • Davies J; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Monteiro E; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Gete M; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Witterick I; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Sadeghi N; Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
  • Richardson K; Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
  • Shenouda G; Department of Radiation Oncology, McGill University Heath Center, Montreal, Quebec, Canada.
  • Maniakas A; Department Otolaryngology-Head and Neck Surgery, Hôpital Maisonneuve-Rosemont, Université de Montreal, Montreal, Quebec, Canada.
  • Landry V; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Gupta M; Department Otolaryngology-Head and Neck Surgery, Hôpital Maisonneuve-Rosemont, Université de Montreal, Montreal, Quebec, Canada.
  • Zhou K; Department of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Mlynarek AM; Department of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
  • Pusztaszeri M; Department of Otolaryngology Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
  • Sultanem K; Department of Pathology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
  • Hier MP; Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Cancer ; 129(20): 3263-3274, 2023 10 15.
Article em En | MEDLINE | ID: mdl-37401841
ABSTRACT

BACKGROUND:

The objective of this study was to examine the utility of postoperative radiation for low and intermediate grade cancers of the parotid and submandibular glands.

METHODS:

The authors conducted a retrospective, Canadian-led, international, multi-institutional analysis of a patient cohort with low or intermediate grade salivary gland cancer of the parotid or submandibular gland who were treated from 2010 until 2020 with or without postoperative radiation therapy. A multivariable, marginal Cox proportional hazards regression analysis was performed to quantify the association between locoregional recurrence (LRR) and receipt of postoperative radiation therapy while accounting for patient-level factors and the clustering of patients by institution.

RESULTS:

In total, 621 patients across 14 tertiary care centers were included in the study; of these, 309 patients (49.8%) received postoperative radiation therapy. Tumor histologies included 182 (29.3%) acinic cell carcinomas, 312 (50.2%) mucoepidermoid carcinomas, and 137 (20.5%) other low or intermediate grade primary salivary gland carcinomas. Kaplan-Meier LRR-free survival at 10 years was 89.0% (95% confidence interval [CI], 84.9%-93.3%). In multivariable Cox regression analysis, postoperative radiation therapy was independently associated with a lower hazard of LRR (adjusted hazard ratio, 0.53; 95% CI, 0.29-0.97). The multivariable model estimated that the marginal probability of LRR within 10 years was 15.4% without radiation and 8.8% with radiation. The number needed to treat was 16 patients (95% CI, 14-18 patients). Radiation therapy had no benefit in patients who had early stage, low-grade salivary gland cancer without evidence of nodal disease and negative margins.

CONCLUSIONS:

Postoperative radiation therapy may reduce LLR in some low and intermediate grade salivary gland cancers with adverse features, but it had no benefit in patients who had early stage, low-grade salivary gland cancer with negative margins.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias das Glândulas Salivares / Recidiva Local de Neoplasia Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias das Glândulas Salivares / Recidiva Local de Neoplasia Idioma: En Ano de publicação: 2023 Tipo de documento: Article