Results of photon radiotherapy for unresectable salivary gland tumors: Is neutron radiotherapy's local control superior?

Daniel E. Spratt, Lucas Resende Salgado, Nadeem Riaz, Michael G. Doran, Moses Tam, Suzanne Wolden, Evangelia Katsoulakis, Shyam Rao, Alan Ho, Richard Wong, Nancy Y. Lee

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background. The results of RTOG-MRC randomized trial of photon (n=15) versus neutron (n=17) therapy in the 1980's reported an improved local control (LC) with neutron radiotherapy for unresectable salivary gland tumors. Due to increased severe toxicity with neutron radiotherapy and the paucity of neutron-therapy centers, we analyzed our institution's results of photon radiotherapy for unresectable salivary gland tumors. Patients and methods. From 1990 to 2009, 27 patients with unresectable salivary gland cancer underwent definitive photon radiotherapy at our institution. Nodal involvement on presentation was found in 9 patients. Median dose of radiotherapy was 70 Gy. Chemotherapy was given to 18 patients, most being platinum-based regimens. Local control (LC), locoregional control (LRC), distant metastasis-free survival (DMFS), overall survival (OS), and toxicity outcomes were assessed. Results. With a median follow-up of 52.4 months, the 2/5-year actuarial LC was 69% (95%CI ± 21.0%)/55% (± 24.2%), LRC was 65% (± 21.4%)/47% (± 21.6%), and DMFS was 71% (± 21.8%)/51% (± 22.8%), respectively using competing risk analysis. The median OS was 25.7 months, and the 2/5-year OS rates were 50% (± 19.0%)/29% (± 16.6%), respectively. Higher histologic grade was significant for an increased rate of DM (intermediate grade vs. low grade, p=0.04, HR 7.93; high grade vs. low grade, p=0.01, HR 13.50). Thirteen (48%) patient's experienced acute grade 3 toxicity. Late grade 3 toxicity occurred in three (11%) patients. Conclusions. Our data compares favorably to neutron radiotherapy with fewer late complications. Photon radiotherapy is an acceptable alternative to neutron radiotherapy in patients who present with unresectable salivary gland tumors.

Original languageEnglish (US)
Pages (from-to)56-61
Number of pages6
JournalRadiology and Oncology
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Glandular and Epithelial Neoplasms
Neutrons
Photons
Radiotherapy
Survival
Salivary Gland Neoplasms
Neoplasm Metastasis
Platinum
Survival Rate
Drug Therapy
Therapeutics

Keywords

  • IMRT
  • Neutron
  • Photon
  • Radiotherapy
  • Salivary gland cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Results of photon radiotherapy for unresectable salivary gland tumors : Is neutron radiotherapy's local control superior? / Spratt, Daniel E.; Salgado, Lucas Resende; Riaz, Nadeem; Doran, Michael G.; Tam, Moses; Wolden, Suzanne; Katsoulakis, Evangelia; Rao, Shyam; Ho, Alan; Wong, Richard; Lee, Nancy Y.

In: Radiology and Oncology, Vol. 48, No. 1, 01.01.2014, p. 56-61.

Research output: Contribution to journalArticle

Spratt, DE, Salgado, LR, Riaz, N, Doran, MG, Tam, M, Wolden, S, Katsoulakis, E, Rao, S, Ho, A, Wong, R & Lee, NY 2014, 'Results of photon radiotherapy for unresectable salivary gland tumors: Is neutron radiotherapy's local control superior?', Radiology and Oncology, vol. 48, no. 1, pp. 56-61. https://doi.org/10.2478/raon-2013-0046
Spratt, Daniel E. ; Salgado, Lucas Resende ; Riaz, Nadeem ; Doran, Michael G. ; Tam, Moses ; Wolden, Suzanne ; Katsoulakis, Evangelia ; Rao, Shyam ; Ho, Alan ; Wong, Richard ; Lee, Nancy Y. / Results of photon radiotherapy for unresectable salivary gland tumors : Is neutron radiotherapy's local control superior?. In: Radiology and Oncology. 2014 ; Vol. 48, No. 1. pp. 56-61.
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abstract = "Background. The results of RTOG-MRC randomized trial of photon (n=15) versus neutron (n=17) therapy in the 1980's reported an improved local control (LC) with neutron radiotherapy for unresectable salivary gland tumors. Due to increased severe toxicity with neutron radiotherapy and the paucity of neutron-therapy centers, we analyzed our institution's results of photon radiotherapy for unresectable salivary gland tumors. Patients and methods. From 1990 to 2009, 27 patients with unresectable salivary gland cancer underwent definitive photon radiotherapy at our institution. Nodal involvement on presentation was found in 9 patients. Median dose of radiotherapy was 70 Gy. Chemotherapy was given to 18 patients, most being platinum-based regimens. Local control (LC), locoregional control (LRC), distant metastasis-free survival (DMFS), overall survival (OS), and toxicity outcomes were assessed. Results. With a median follow-up of 52.4 months, the 2/5-year actuarial LC was 69{\%} (95{\%}CI ± 21.0{\%})/55{\%} (± 24.2{\%}), LRC was 65{\%} (± 21.4{\%})/47{\%} (± 21.6{\%}), and DMFS was 71{\%} (± 21.8{\%})/51{\%} (± 22.8{\%}), respectively using competing risk analysis. The median OS was 25.7 months, and the 2/5-year OS rates were 50{\%} (± 19.0{\%})/29{\%} (± 16.6{\%}), respectively. Higher histologic grade was significant for an increased rate of DM (intermediate grade vs. low grade, p=0.04, HR 7.93; high grade vs. low grade, p=0.01, HR 13.50). Thirteen (48{\%}) patient's experienced acute grade 3 toxicity. Late grade 3 toxicity occurred in three (11{\%}) patients. Conclusions. Our data compares favorably to neutron radiotherapy with fewer late complications. Photon radiotherapy is an acceptable alternative to neutron radiotherapy in patients who present with unresectable salivary gland tumors.",
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T2 - Is neutron radiotherapy's local control superior?

AU - Spratt, Daniel E.

AU - Salgado, Lucas Resende

AU - Riaz, Nadeem

AU - Doran, Michael G.

AU - Tam, Moses

AU - Wolden, Suzanne

AU - Katsoulakis, Evangelia

AU - Rao, Shyam

AU - Ho, Alan

AU - Wong, Richard

AU - Lee, Nancy Y.

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N2 - Background. The results of RTOG-MRC randomized trial of photon (n=15) versus neutron (n=17) therapy in the 1980's reported an improved local control (LC) with neutron radiotherapy for unresectable salivary gland tumors. Due to increased severe toxicity with neutron radiotherapy and the paucity of neutron-therapy centers, we analyzed our institution's results of photon radiotherapy for unresectable salivary gland tumors. Patients and methods. From 1990 to 2009, 27 patients with unresectable salivary gland cancer underwent definitive photon radiotherapy at our institution. Nodal involvement on presentation was found in 9 patients. Median dose of radiotherapy was 70 Gy. Chemotherapy was given to 18 patients, most being platinum-based regimens. Local control (LC), locoregional control (LRC), distant metastasis-free survival (DMFS), overall survival (OS), and toxicity outcomes were assessed. Results. With a median follow-up of 52.4 months, the 2/5-year actuarial LC was 69% (95%CI ± 21.0%)/55% (± 24.2%), LRC was 65% (± 21.4%)/47% (± 21.6%), and DMFS was 71% (± 21.8%)/51% (± 22.8%), respectively using competing risk analysis. The median OS was 25.7 months, and the 2/5-year OS rates were 50% (± 19.0%)/29% (± 16.6%), respectively. Higher histologic grade was significant for an increased rate of DM (intermediate grade vs. low grade, p=0.04, HR 7.93; high grade vs. low grade, p=0.01, HR 13.50). Thirteen (48%) patient's experienced acute grade 3 toxicity. Late grade 3 toxicity occurred in three (11%) patients. Conclusions. Our data compares favorably to neutron radiotherapy with fewer late complications. Photon radiotherapy is an acceptable alternative to neutron radiotherapy in patients who present with unresectable salivary gland tumors.

AB - Background. The results of RTOG-MRC randomized trial of photon (n=15) versus neutron (n=17) therapy in the 1980's reported an improved local control (LC) with neutron radiotherapy for unresectable salivary gland tumors. Due to increased severe toxicity with neutron radiotherapy and the paucity of neutron-therapy centers, we analyzed our institution's results of photon radiotherapy for unresectable salivary gland tumors. Patients and methods. From 1990 to 2009, 27 patients with unresectable salivary gland cancer underwent definitive photon radiotherapy at our institution. Nodal involvement on presentation was found in 9 patients. Median dose of radiotherapy was 70 Gy. Chemotherapy was given to 18 patients, most being platinum-based regimens. Local control (LC), locoregional control (LRC), distant metastasis-free survival (DMFS), overall survival (OS), and toxicity outcomes were assessed. Results. With a median follow-up of 52.4 months, the 2/5-year actuarial LC was 69% (95%CI ± 21.0%)/55% (± 24.2%), LRC was 65% (± 21.4%)/47% (± 21.6%), and DMFS was 71% (± 21.8%)/51% (± 22.8%), respectively using competing risk analysis. The median OS was 25.7 months, and the 2/5-year OS rates were 50% (± 19.0%)/29% (± 16.6%), respectively. Higher histologic grade was significant for an increased rate of DM (intermediate grade vs. low grade, p=0.04, HR 7.93; high grade vs. low grade, p=0.01, HR 13.50). Thirteen (48%) patient's experienced acute grade 3 toxicity. Late grade 3 toxicity occurred in three (11%) patients. Conclusions. Our data compares favorably to neutron radiotherapy with fewer late complications. Photon radiotherapy is an acceptable alternative to neutron radiotherapy in patients who present with unresectable salivary gland tumors.

KW - IMRT

KW - Neutron

KW - Photon

KW - Radiotherapy

KW - Salivary gland cancer

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