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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,<ref>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</ref> and has shown to be significantly more effective than photons in studies treating unresectable salivary gland tumors.<ref>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.</ref><ref>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</ref>


==References==
==References==

Revision as of 21:46, 10 November 2015

Salivary gland tumor Microchapters

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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


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