Adjuvant radiotherapy in parotid gland pleomorphic adenoma - recommendations

Abstract

Introduction: Standard treatment for pleomorhic adenoma (PA) of the parotid gland is complete surgical excision. Radiotherapy (RT) as a primary treatment method is controversial and generally is not applied. However RT might be considered as an adjuvant therapy in some selected cases. Aim: Aim of this work was to define recommendations for RT in patients with parotid gland PA after primary surgical treatment Methods: Based on the results currently published in the literature and the authors' own experiences from leading Polish laryngological and oncological clinical centers dealing with the treatment of the salivary gland tumors, the indications for irradiation and its methods in patients with PA of the salivary glands were discussed. Results: Authors recommend personalized treatment based on multidisciplinary panel decision in each patient. Adjuvant RT should be considered in cases of suboptimal resection of primary PA (close margin, intraoperative tumor spillage, risk of recurrence based on clinical factors and histological features), and in cases of PA recurrence. Doses/fractions and techniques of irradiation are recommended depending on clinical extension of the primary or recurrent tumor. Conclusions: Adjuvant RT in PA treatment should be a result of personalized multidisciplinary decision after considering all possible risks of irradiation consequences. Recommendations for this treatment should be taken into consideration.