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Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

  • Kim, Tae Hyung (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Kim, Mi Sun (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Choi, Seo Hee (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Suh, Yang Gun (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine) ;
  • Koh, Yoon Woo (Department of Otorhinolaryngology, Yonsei University College of Medicine) ;
  • Kim, Se Hun (Department of Otorhinolaryngology, Yonsei University College of Medicine) ;
  • Choi, Eun Chang (Department of Otorhinolaryngology, Yonsei University College of Medicine) ;
  • Keum, Ki Chang (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
  • Received : 2014.04.22
  • Accepted : 2014.06.23
  • Published : 2014.09.30

Abstract

Purpose: We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. Materials and Methods: A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Results: Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Conclusion: Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

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