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    Indications for salivary gland radiotherapy.

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    Authors
    Thomson, David J
    Slevin, Nicholas J
    Mendenhall, W
    Affiliation
    Department of Clinical Oncology, The Christie NHS FT, Manchester
    Issue Date
    2016
    
    Metadata
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    Abstract
    There is an established role for post-operative radiotherapy in the treatment of benign and malignant salivary gland tumours. For benign disease, the addition of radiotherapy improves local tumour control in cases with incomplete excision, involved surgical margins or multi-focal disease recurrence. After capsule rupture or spillage alone, surveillance should usually be advised. For malignant disease, post-operative radiotherapy is recommended for an advanced tumour stage, high-grade tumour, perineural or lympho-vascular invasion, close or positive resection margins, extra-parotid extension or lymph node involvement. The main benefit is increased loco-regional tumour control, although this may translate into a modest improvement in survival. The possible late side effects of parotid bed irradiation include skin changes, chronic otitis externa, sensorineural hearing loss, osteoradionecrosis and secondary malignancy. Severe complications are rare, but patients should be counselled carefully about the risks. Primary radiotherapy is unlikely to be curative and is reserved to cases in which resection would cause unacceptable functional or cosmetic morbidity or would likely result in subtotal resection (R2) or to patients with distant metastases to gain local tumour control. There are provisional data on the use of charged particle radiotherapy in this setting. Some patients may benefit from synchronous chemotherapy with radiotherapy, but this group is not defined, and data from comparative prospective studies are required before routine clinical use of this treatment.
    Citation
    Indications for salivary gland radiotherapy. 2016, 78:141-7 Adv. Otorhinolaryngol
    Journal
    Advances in oto-rhino-laryngology
    URI
    http://hdl.handle.net/10541/606885
    DOI
    10.1159/000442134
    PubMed ID
    27093301
    Type
    Article
    Language
    en
    ISSN
    1662-2847
    ae974a485f413a2113503eed53cd6c53
    10.1159/000442134
    Scopus Count
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