Salivary gland tumor medical therapy

Salivary gland tumor Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Salivary gland tumor from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Fine-needle Aspiration Biopsy (FNAB)
Head X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Salivary gland tumor medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Salivary gland tumor medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Salivary gland tumor medical therapy
CDC on Salivary gland tumor medical therapy
Salivary gland tumor medical therapy in the news
Blogs on Salivary gland tumor medical therapy
Directions to Hospitals Treating Salivary gland tumor
Risk calculators and risk factors for Salivary gland tumor medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

The optimal therapy for salivary gland tumors depends on the stage at diagnosis. The mainstay of therapy for salivary gland tumors is surgery. External beam radiation therapy may be used following surgery, when surgery is not possible, or would cause significant complications. Chemotherapy is considered when radiation therapy or surgery is refused.

Medical Therapy

Surgery is usually done to remove the affected salivary gland. No other treatment is needed, if the tumor is benign. If the tumor is cancerous, radiation therapy or extensive surgery may be needed. Chemotherapy is used when the cancer has spread beyond the salivary glands. Treatment plans are designed to meet the unique needs of each person with cancer. Treatment decisions for salivary gland cancer are based on:

• Stage of the cancer
• Grade of the cancer
• Anatomical site of cancer

Treatment options for salivary cancer

• Surgery
• Radiation therapy
  • External beam radiation therapy may be used following surgery, or when surgery is not possible or would cause significant complications.
• Chemotherapy
  • The role of chemotherapy has not been firmly established, although there is some evidence that it may be effective in treating some salivary gland cancers. It is most often used during clinical trials. Sometimes chemotherapy is used when an individual chooses not to have radiation therapy or surgery. It may also be used for recurrent tumours or for tumors that do not respond to surgery and radiation therapy.
• Follow-up after treatment is finished
  • It is important to have regular follow-up visits, especially in the first few years after treatment.
• The following table illustrates the treatment therapy available for salivary gland tumors:

Stage	Grade	Treatment
Stage I major salivary gland cancer	Low-grade tumors	Surgery alone
		Postoperative radiation therapy should be considered when the resection margins are positive
	High-grade tumors	Localized high-grade salivary gland tumors that are confined to the gland in which they arise may be cured by radical surgery alone
		Postoperative radiation therapy may improve local control and increase survival rates for patients with high-grade tumors, positive surgical margins, or perineural invasion
Stage II major salivary gland cancer	Low-grade tumors	Surgery alone or with postoperative radiation therapy, if indicated, is appropriate
		Chemotherapy should be considered in special circumstances, such as when radiation therapy or surgery is refused
	High-grade tumors	Localized high-grade salivary gland tumors that are confined to the gland in which they arise may be cured by radical surgery alone
		Postoperative radiation therapy may improve local control and increase survival rates for patients with high-grade tumors, positive surgical margins, or perineural invasion
		Fast neutron-beam radiation therapy or accelerated hyperfractionated photon-beam schedules reportedly are more effective than conventional x-ray therapy in the treatment of patients with inoperable, unresectable, or recurrent malignant salivary gland tumors
Stage III major salivary gland cancer	Low-grade tumors	Surgery alone or with postoperative radiation therapy, if indicated, is appropriate.
		Chemotherapy should be considered in special circumstances, such as when radiation or surgery is refused or when tumors are recurrent or nonresponsive
	High-grade tumors	Patients with localized high-grade salivary gland tumors that are confined to the gland in which they arise may be cured by radical surgery alone
		Postoperative radiation therapy may improve local control and increase survival rates for patients with high-grade tumors, positive surgical margins, or perineural invasion
		Fast neutron-beam radiation therapy or accelerated hyperfractionated photon-beam schedules have been reported to be more effective than conventional x-ray therapy in the treatment of patients with inoperable, unresectable, or recurrent malignant salivary gland tumors
Stage IV major salivary gland cancer	Standard therapy for patients with tumors that have spread to distant sites is not curative	Fast neutron-beam radiation therapy or accelerated hyperfractionated photon-beam schedules have been reported to be more effective than conventional x-ray therapy in the treatment of patients with inoperable, unresectable, or recurrent malignant salivary gland tumors
Recurrent major salivary gland cancer		Fast neutron-beam radiation therapy is superior to conventional radiation therapy using x-rays and may be curative in selected patients with recurrent disease

References