Radiotherapy for Major Salivary Gland Carcinoma: A Single Institution Experience

KH Au, TS Choy, KC Ngan

Hong Kong J Radiol 2001;4:189-95

Objective: To evaluate the outcome and natural history of patients with major salivary gland carcinomas treated at Queen Elizabeth Hospital between 1982 and 1998.

Patients and Methods: The records of 111 patients with major salivary gland carcinomas who were referred for radiotherapy between 1982 and 1998 were retrospectively reviewed. Seventy-seven patients were treated surgically, followed by postoperative irradiation. The male .female ratio was 1:1 (n= 36 : n=41 ), and the median age for the group was 57 years (range, 21 to 85 years). Patients were staged according to the tumour-node-metastasis staging system of the American Joint Committee on Cancer. Forty four patients had stage I disease, 9 had stage II disease, 5 had stage III disease, and 19 had stage IV disease. Forty four patients (57.2%) had involved or closed resection margins. Twenty four patients (31.2%) had mucoepidermoid carcinoma, 18 (23.4%) had adenocystic carcinoma, 9 (11.7%) had adenocarcinoma, 6 (7.8%) had acinic cell carcinoma, and 20 (26%) had other histological types. Radiotherapy was delivered by megavoltage photons or electrons, or a combination of both; the median tumour dose (in time-dose factor) was 64 Gy. The median follow-up period was 51.3 months.

Results: Overall survival, local failure-free survival, and regional-free survival rates after 5 and 10 years were 82% and 78%, 89% and 85%, and 97% and 91%, respectively. Twenty patients experienced disease recurrence.

Conclusions: Surgical resection and postoperative radiotherapy are well tolerated and effective, with high local control rates.