Lewis A. Rosenberg MD, Presenter: Nothing to Disclose

"Purpose/Objective(s): Chemoradiotherapy (CRT), as compared with radiotherapy (RT) alone, improves the survival of patients with advanced head and neck squamous cell carcinoma (HNSCC). Published 5-year overall survival (OS) for T4 or node positive salivary gland malignancies ranges from 20-55%. Based on the success of CRT in HNSCC and the poor outcome of locoregionally advanced salivary gland malignancies, our institution has empirically treated advanced salivary gland malignancies with CRT. Indications for adding concurrent chemotherapy to RT have been the following: positive margins, nodal extracapsular extension (ECE), gross residual, or unresectable disease. We report the treatment outcomes of CRT for locoregionally advanced salivary gland malignancies.""Material/Methods: We performed a retrospective review of 15 patients with locoregionally advanced non-metastatic salivary gland malignancies treated between 1994 and 2009 with either postoperative or definitive CRT. The probabilities of locoregional control (LRC), distant metastasis free survival (DMFS), event free survival (EFS), and OS rates were calculated by the Kaplan-Meier product-limit method.""Results: The median follow-up for this cohort was 19 months (range = 6 months to 157 months). 8 were treated with postoperative CRT and 7 with definitive CRT. The median age was 62 years (range 30 to 73). The primary tumor location was the following: 13 parotid, 1 submandibular, and 1 minor gland. The stage distribution was the following: 1 stage II, 2 stage III, 7 stage IVA, and 5 stage IVb. Histological types included 7 mucoepidermoid, 2 carcinoma ex-pleomorphic adenoma, 2 adenocarcinoma, 2 undifferentiated, 1 salivary duct, and 1 adenoid cystic. High risk features in this cohort included positive margins (n=2, 13%), nodal ECE (n=4, 27%), and unresectable disease (n=7, 47%). The median radiation dose was 70Gy (range 60 to 72Gy). All patients received platinum based chemotherapy. 2-year results were as follows: LRC = 60%, DMFS = 60%, EFS = 44%, and OS = 67%. No patients had severe or fatal complications. ""Conclusion: The addition of chemotherapy to radiotherapy did not result in a notable improvement in outcomes as compared with published results with RT alone. This cohort, however, represented a particularly high risk group of patients, including many with unresectable disease. "

Rosenberg, L, Chemoradiotherapy for the Treatment of Locoregionally Advanced Salivary Gland Malignancies.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9020113.html