Radiation Therapy for Cutaneous Squamous Cell Carcinoma Involving the Parotid Area Lymph Nodes: Dose and Volume Considerations

Allen M. Chen, Roy C. Grekin, Joaquin Garcia, Mary K. Bucci, Lawrence W. Margolis

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: The intraparotid and periparotid lymph nodes are the most commonly involved when skin cancer of the head and neck metastasizes beyond the primary site. We sought to report the clinical outcome of patients treated with radiation therapy for parotid-area metastases from cutaneous squamous cell carcinoma of the head and neck. Methods and Materials: The records of 36 patients treated with radiation therapy for cutaneous squamous cell carcinoma involving the parotid-area lymph nodes were reviewed. All patients had clinically N0 necks and were without evidence of distant disease. Thirty patients (83%) were treated postoperatively after gross total tumor resection. Median dose to the parotid area was 60 Gy (range, 50-72 Gy). Treatment of clinically N0 necks consisted of surgical dissection (7 patients), irradiation (15 patients), and observation (14 patients). Results: The 5-year estimate of local (parotid) control was 86% in patients treated using surgery with postoperative therapy and 47% in patients treated using radiation therapy alone. Three of 4 patients with tumors that relapsed locally after surgery and postoperative radiation received a dose of less than 60 Gy. Elective neck irradiation decreased the incidence of subsequent nodal failures from 50% to 0% and significantly improved neck control (p < 0.001). The 5-year overall survival rate was 63%. Conclusions: Surgery followed by radiation therapy to doses of at least 60 Gy results in effective local control for patients with parotid area metastasis from cutaneous squamous cell carcinoma. Routine irradiation of the clinically N0 neck is recommended.

Original languageEnglish (US)
Pages (from-to)1377-1380
Number of pages4
JournalInternational Journal of Radiation Oncology Biology Physics
Volume69
Issue number5
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Fingerprint

lymphatic system
Squamous Cell Carcinoma
radiation therapy
Radiotherapy
Lymph Nodes
cancer
dosage
Skin
Neck
surgery
metastasis
irradiation
tumors
Neoplasm Metastasis
dissection
Skin Neoplasms
Head and Neck Neoplasms
Dissection
therapy
Neoplasms

Keywords

  • Parotid
  • Radiation therapy
  • Skin cancer
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Radiation Therapy for Cutaneous Squamous Cell Carcinoma Involving the Parotid Area Lymph Nodes : Dose and Volume Considerations. / Chen, Allen M.; Grekin, Roy C.; Garcia, Joaquin; Bucci, Mary K.; Margolis, Lawrence W.

In: International Journal of Radiation Oncology Biology Physics, Vol. 69, No. 5, 01.12.2007, p. 1377-1380.

Research output: Contribution to journalArticle

Chen, Allen M. ; Grekin, Roy C. ; Garcia, Joaquin ; Bucci, Mary K. ; Margolis, Lawrence W. / Radiation Therapy for Cutaneous Squamous Cell Carcinoma Involving the Parotid Area Lymph Nodes : Dose and Volume Considerations. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 69, No. 5. pp. 1377-1380.
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AB - Purpose: The intraparotid and periparotid lymph nodes are the most commonly involved when skin cancer of the head and neck metastasizes beyond the primary site. We sought to report the clinical outcome of patients treated with radiation therapy for parotid-area metastases from cutaneous squamous cell carcinoma of the head and neck. Methods and Materials: The records of 36 patients treated with radiation therapy for cutaneous squamous cell carcinoma involving the parotid-area lymph nodes were reviewed. All patients had clinically N0 necks and were without evidence of distant disease. Thirty patients (83%) were treated postoperatively after gross total tumor resection. Median dose to the parotid area was 60 Gy (range, 50-72 Gy). Treatment of clinically N0 necks consisted of surgical dissection (7 patients), irradiation (15 patients), and observation (14 patients). Results: The 5-year estimate of local (parotid) control was 86% in patients treated using surgery with postoperative therapy and 47% in patients treated using radiation therapy alone. Three of 4 patients with tumors that relapsed locally after surgery and postoperative radiation received a dose of less than 60 Gy. Elective neck irradiation decreased the incidence of subsequent nodal failures from 50% to 0% and significantly improved neck control (p < 0.001). The 5-year overall survival rate was 63%. Conclusions: Surgery followed by radiation therapy to doses of at least 60 Gy results in effective local control for patients with parotid area metastasis from cutaneous squamous cell carcinoma. Routine irradiation of the clinically N0 neck is recommended.

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