Treatment of Salivary Gland Neoplasms With Fast Neutron Radiotherapy | Oncology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
September 2003

Treatment of Salivary Gland Neoplasms With Fast Neutron Radiotherapy

Author Affiliations

From the Departments of Radiation Oncology (Drs Douglas, Koh, Austin-Seymour, and Laramore), Pediatrics (Dr Douglas), and Neurological Surgery (Dr Douglas), University of Washington Cancer Center, Seattle. The authors have no relevant financial interest in this article.

Arch Otolaryngol Head Neck Surg. 2003;129(9):944-948. doi:10.1001/archotol.129.9.944

Objective  To evaluate the efficacy of fast neutron radiotherapy for the treatment of salivary gland neoplasms.

Design  Retrospective analysis.

Setting  University of Washington Cancer Center, Neutron Facility, Seattle.

Patients  The medical records of 279 patients treated with curative intent using fast neutron radiotherapy at the University of Washington Cancer Center were reviewed. Of the 279 patients, 263 had evidence of gross residual disease at the time of treatment (16 had no evidence of gross residual disease), 141 had tumors of a major salivary gland, and 138 had tumors of minor salivary glands. The median follow-up period was 36 months (range, 1-142 months).

Main Outcome Measures  Local-regional control, cause-specific survival, and freedom from metastasis.

Results  The 6-year actuarial cause-specific survival rate was 67%. Multivariate analysis revealed that low group stage (I-II) disease, minor salivary sites, lack of skull base invasion, and primary disease were associated with a statistically significant improvement in cause-specific survival. The 6-year actuarial local-regional control rate was 59%. Multivariate analysis revealed size 4 cm or smaller, lack of base of skull invasion, prior surgical resection, and no previous radiotherapy to have a statistically significant improved local-regional control. Sixteen patients without evidence of gross residual disease had a 100% 6-year actuarial local-regional control. The 6-year actuarial freedom from metastasis rate was 64%. Factors associated with decreased development of systemic metastases included negative lymph nodes at the time of treatment and lack of base of skull involvement. The 6-year actuarial rate of development of grade 3 or 4 long-term toxicity (using the Radiation Therapy Oncology Group and European Organization for Research on the Treatment of Cancer criteria) was 10%. No patient experienced grade 5 toxic effects.

Conclusions  Neuron radiotherapy is an effective treatment for patients with salivary gland neoplasms who have gross residual disease and achieves excellent local-regional control in patients without evidence of gross disease.