Salivary gland tumor medical therapy: Difference between revisions
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{| class="wikitable" | {| class="wikitable" | ||
! Stage | ! style="font-weight: bold;" | Stage | ||
! Grade | ! style="font-weight: bold;" | Grade | ||
! Treatment | ! style="font-weight: bold;" | Treatment | ||
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| Stage I major salivary gland cancer | | style="font-weight: bold;" | Stage I major salivary gland cancer | ||
| Low-grade tumors | | Low-grade tumors | ||
| Surgery alone | | Surgery alone | ||
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| Postoperative radiation therapy may improve local control and increase survival rates for patients with high-grade tumors, positive surgical margins, or perineural invasion | | 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 | | style="font-weight: bold;" | Stage II major salivary gland cancer | ||
| Low-grade tumors | | Low-grade tumors | ||
| Surgery alone or with postoperative radiation therapy, if indicated, is appropriate | | Surgery alone or with postoperative radiation therapy, if indicated, is appropriate | ||
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| 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 | | 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 | | style="font-weight: bold;" | Stage III major salivary gland cancer | ||
| Low-grade tumors | | Low-grade tumors | ||
| Surgery alone or with postoperative radiation therapy, if indicated, is appropriate. | | Surgery alone or with postoperative radiation therapy, if indicated, is appropriate. | ||
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| 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 | | 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 | | style="font-weight: bold;" | Stage IV major salivary gland cancer | ||
| Standard therapy for patients with tumors that have spread to distant sites is not curative | | 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 | | 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 | | style="font-weight: bold;" | 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 | | Fast neutron-beam radiation therapy is superior to conventional radiation therapy using x-rays and may be curative in selected patients with recurrent disease | ||
Revision as of 18:43, 10 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
| 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 |
MediaWiki tables support
MediaWiki is a free open sou If the cancer is high-grade, treatment may include the following for all the 4 stages of tumor:
- Radiation therapy may be given after surgery.
- Fast neutron radiation therapy.
- Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
- A clinical trial of radiation therapy and/or radiosensitizers.
- A clinical trial of chemotherapy.
For stages I, II and III surgery is the main stay of treatment.
Radiation Therapy
Fast neutron therapy has been used successfully to treat salivary gland tumors,[1] and has shown to be significantly more effective than photons in studies treating unresectable salivary gland tumors.[2][3]
References
- ↑ Douglas JD, Koh WJ , Austin-Seymour, M, Laramore GE. Treatment of Salivary Gland Neoplasms with fast neutron Radiotherapy. Arch Otolaryngol Head Neck Surg Vol 129 944-948 Sep 2003
- ↑ Laramore GE, Krall JM, Griffin TW, Duncan W, Richter MP, Saroja KR, Maor MH, Davis LW. Neutron versus photon irradiation for unresectable salivary gland tumors: final report of an RTOG-MRC randomized clinical trial. Int J Radiat Oncol Biol Phys. 1993 Sep 30;27(2):235-40.
- ↑ Krüll A, Schwarz R, Engenhart R, et al.: European results in neutron therapy of malignant salivary gland tumors. Bull Cancer Radiother 83 (Suppl): 125-9s, 1996