Postoperative radiation therapy for parotid pleomorphic adenoma with close or positive margins: Treatment outcomes and toxicities

Shyamal Patel, Waleed Fouad Mourad, Chengtao Wang, Bhaswant Dhanireddy, Catherine Concert, Magdalena Ryniak, Azita S. Khorsandi, Rania A. Shourbaji, Zujun Li, Bruce Culliney, Rajal Patel, Richard L. Bakst, Theresa Tran, Daniel Shasha, Stimson Schantz, Mark S. Persky, Kenneth S. Hu, Louis B. Harrison

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Aim: To evaluate the locoregional control and treatment toxicity of patients with pleomorphic adenoma after resection with close or positive margins followed by postoperative radiation therapy (PORT). Patients and Methods: Between 2002 and 2011, twenty-one patients underwent PORT at the Mount Sinai Beth Israel Medical Center for pleomorphic adenoma of the parotid with close or positive margins. Four out of the 21 patients (19%) had recurrent lesions. The median dose was 57.6 Gy (range 55.8-69.96) delivered at 1.8-2.12 Gy/fraction. Treatment and follow-up data were retrospectively analyzed for locoregional control as well as acute- and late-treatment toxicities. Actuarial survival analysis was also performed. Results: Twelve women and 9 men with a median age of 46 (26-65) at PORT were included in this study. Eighty-one percent of the cohort had positive resection margins while 19% had close margins. At a median follow-up of 92 months, 19/21 patients (90%) had locoregional control. Two patients who failed had primary lesions which recurred locally, and initially had positive margins. The two recurrences occurred at 8 months and 12 months. Acute Radiation Therapy Oncology Group (RTOG) grade 1 and 2 toxicities were experienced by 11 (52%) and 4 (19%) patients, respectively, while 2 (10%) experienced late RTOG grade 1 toxicities. No patients experienced any grade 2-4 late toxicities. Actuarial survival was 100%. Conclusion: PORT for patients with pleomorphic adenoma of the parotid gland after resection with close or positive margins results in excellent locoregional control and low treatment-related morbidity.

Original languageEnglish (US)
Pages (from-to)4247-4252
Number of pages6
JournalAnticancer research
Volume34
Issue number8
StatePublished - Aug 1 2014

Keywords

  • Benign
  • Close margins
  • Local control
  • Parotid
  • Pleomorphic adenoma
  • Positive margins
  • Postoperative radiation
  • Postoperative radiotherapy
  • Radiation toxicity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Patel, S., Mourad, W. F., Wang, C., Dhanireddy, B., Concert, C., Ryniak, M., Khorsandi, A. S., Shourbaji, R. A., Li, Z., Culliney, B., Patel, R., Bakst, R. L., Tran, T., Shasha, D., Schantz, S., Persky, M. S., Hu, K. S., & Harrison, L. B. (2014). Postoperative radiation therapy for parotid pleomorphic adenoma with close or positive margins: Treatment outcomes and toxicities. Anticancer research, 34(8), 4247-4252.