NEW YORK (Reuters Health) Nov 01 - Adjuvant radiation appears to help patients with high-risk tumors in major salivary glands, according to a study in the October issue of Archives of Otolaryngology -- Head & Neck Surgery
The new findings, drawn from a national cancer database, show that radiotherapy against high grade and locally advanced malignant salivary gland tumors "was associated with improved survival," lead author Dr. Usama Mahmood told Reuters Health by email.
Dr. Mahmood and colleagues at the University of Maryland in Baltimore note that although a number of retrospective studies showed adjuvant radiation improved local control, few reported a significant survival benefit. Given the low incidence major salivary gland malignancies, there have been no randomized controlled trials.
Dr. Mahmood's team examined data on 2,170 adults who had surgery for high-grade disease, including 1,565 (72%) who received adjuvant radiotherapy. The median age was 68.
Although the radiotherapy patients were younger (with a median age of 67, vs 71 for patients who didn't receive radiotherapy), their tumors fell into higher T and N categories. Even so, multivariable analysis showed significantly improved survival in that group(hazard ratio, 0.76; p <0.001).
Patients who particularly benefited from radiotherapy were those with involvement of the parotid gland or squamous cell carcinoma. There was also a survival benefit for patients with adenocarcinoma, but not a statistically significant one.
Younger age at diagnosis, less radical surgery, and lower T and N categories were also among the factors associated with improved survival.
"Further prospective studies are warranted to examine the role of radiation therapy in the management of this disease," the research team concludes.
SOURCE: http://bit.ly/ts9y4D
Arch Otolaryngol Head Neck Surg 2011;137:1025-1030.
The new findings, drawn from a national cancer database, show that radiotherapy against high grade and locally advanced malignant salivary gland tumors "was associated with improved survival," lead author Dr. Usama Mahmood told Reuters Health by email.
Dr. Mahmood and colleagues at the University of Maryland in Baltimore note that although a number of retrospective studies showed adjuvant radiation improved local control, few reported a significant survival benefit. Given the low incidence major salivary gland malignancies, there have been no randomized controlled trials.
Dr. Mahmood's team examined data on 2,170 adults who had surgery for high-grade disease, including 1,565 (72%) who received adjuvant radiotherapy. The median age was 68.
Although the radiotherapy patients were younger (with a median age of 67, vs 71 for patients who didn't receive radiotherapy), their tumors fell into higher T and N categories. Even so, multivariable analysis showed significantly improved survival in that group(hazard ratio, 0.76; p <0.001).
Patients who particularly benefited from radiotherapy were those with involvement of the parotid gland or squamous cell carcinoma. There was also a survival benefit for patients with adenocarcinoma, but not a statistically significant one.
Younger age at diagnosis, less radical surgery, and lower T and N categories were also among the factors associated with improved survival.
"Further prospective studies are warranted to examine the role of radiation therapy in the management of this disease," the research team concludes.
SOURCE: http://bit.ly/ts9y4D
Arch Otolaryngol Head Neck Surg 2011;137:1025-1030.
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου