Il Valore Della Radioterapia Nel Trattamento Dei Tumori Delle Ghiandole Salivari: (rendiconto clinico-statistico dei casi trattati dal 1928 al 1950)

Abstract

The discrepancy existing among radiotherapeutical results in the treatment of salivary glands tumours, and chiefly of mixed tumours of the parotid gland, suggested this study, based on a clinico-statistical survey of all cases of primary tumours radiologically treated from 1928 to 1951 at the Radiological Institute of the University and Cancer Institute of Milan. After a histological classification of the cases (64), anamnestic, clinical, histopathological, therapeutical and course data are tabulated in detail. As the therapeutical problem of the salivary glands tumours is necessarily connected with the surgical operation, the literature on that subject has been thoroughly reviewed and the opportunity of radicality in mixed parotid tumours discussed. But, as surgery proved to be insufficient in the treatment of these tumours, the emploiment of a complementary post-operative radiotherapy is suggested for malignant tumours and for benign mixed tumours as well. Only a clinical diagnosis is possible, being biopsy contraindicated. Basing on the experience derived from the considered cases, criteria are exposed which are of practical value for the treatment of tumours of the salivary glands: a) in operable parotid tumours, partial parotidectomy (enucleoresection or superficial lobectomy) followed in all cases by complementary radiotherapy. A radical operation with removal of the facial nerve and, eventually, radical removal of the neck lymphatics, will be taken into consideration only in case of histologically proved malignancy of the operatory specimen; b) in operable tumours localized to the other salivary glands, radical removal followed by post-operatory complementary radiotherapy in doses suited to the histological type; c) in clearly malignant inoperable tumours, roentgen- or curietherapy, which may occasionally determine remarkable regressions thus allowing a further radical operation.