Radiation Therapy After Surgical Resection Improves Outcomes for Patients With Recurrent Pleomorphic Adenoma
| Autor: | Harry Quon, David W. Eisele, Luka Vujaskovic, Carole Fakhry, Sarah Nicholas, Christine G. Gourin, Justin A. Bishop, Angela L. Liang, Wei Fu, Brandi R. Page, Ana P. Kiess, Regina DeLuna |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis medicine.medical_treatment R895-920 030218 nuclear medicine & medical imaging Pleomorphic adenoma 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine medicine Radiology Nuclear Medicine and imaging Scientific Article RC254-282 business.industry Proportional hazards model Medical record Hazard ratio Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Confidence interval Radiation therapy Oncology 030220 oncology & carcinogenesis Radiology business Adjuvant |
| Zdroj: | Advances in Radiation Oncology Advances in Radiation Oncology, Vol 6, Iss 3, Pp 100674-(2021) |
| ISSN: | 2452-1094 |
| Popis: | Purpose: Pleomorphic adenoma is a benign salivary tumor that may recur multifocally. In case series, the benefit of radiation therapy (RT) for recurrent pleomorphic adenoma remains unclear. We hypothesized that the combination of surgery and adjuvant RT reduces risk of subsequent recurrence compared with surgery alone for recurrent pleomorphic adenoma. Methods and Materials: Patients who received diagnoses of recurrent pleomorphic adenoma between 1980 and 2016 were identified using an institutional pathology database. Medical records were retrospectively reviewed to determine clinical, operative, pathologic, and imaging characteristics. Kaplan-Meier methods were used to estimate local control after surgery, stratified by completeness of resection and receipt of adjuvant RT. The association of variables with risk of subsequent local recurrence was analyzed using Cox proportional hazards model, and variance estimates were calculated to account for multiple recurrences in the same patient. Toxicities were prospectively recorded in a departmental database. Results: A total of 49 patients presented with at least 1 recurrence, of which 28 were managed with surgery alone, and 21 were treated with surgery and RT. The median follow-up time after the initial recurrence was 48 months (range, 6-531 months). There were 35 subsequent recurrences; 34 after surgery alone and only 1 after surgery with RT. On multivariate analysis, adjuvant RT was associated with decreased risk of recurrence (hazard ratio, 0.09; 95% confidence interval, 0.02-0.41, P = .002), whereas increasing number of prior recurrences was associated with increased risk (hazard ratio, 1.23; 95% confidence interval, 1.13-1.35, P < .001). Common toxicities of RT included dermatitis, xerostomia, and mucositis. Conclusions: For patients with recurrent pleomorphic adenoma, the addition of adjuvant RT after surgery is associated with a significant decrease in risk of subsequent tumor recurrence. |
| Databáze: | OpenAIRE |
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