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Adjuvant therapy in the management of operable salivary duct carcinoma: correlating evidence with a retrospective review

Published online by Cambridge University Press:  10 February 2021

Jeyaanth Venkatasai Open the ORCID record for Jeyaanth Venkatasai [Opens in a new window] ,
Anindita Das Open the ORCID record for Anindita Das [Opens in a new window] ,
Punitha Kaliamurthi ,
Balu Krishna Sasidharan Open the ORCID record for Balu Krishna Sasidharan [Opens in a new window] ,
Manu Mathew ,
Ashish Singh ,
Aparna Irodi ,
Meera Thomas ,
Subhashini John  and
Rajiv C. Michael
...Show all authors
Jeyaanth Venkatasai
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Anindita Das
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Punitha Kaliamurthi
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Balu Krishna Sasidharan*
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Manu Mathew
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Ashish Singh
Affiliation:
Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu632004, India
Aparna Irodi
Affiliation:
Division of Clinical Radiology, Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu632004, India
Meera Thomas
Affiliation:
Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu632004, India
Subhashini John
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Rajiv C. Michael
Affiliation:
Department of Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu632004, India
Amit J. Tirkey
Affiliation:
Department of Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu632004, India
Rajesh Isiah
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
Simon Pavamani
Affiliation:
Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India
*
Author for correspondence: Balu Krishna Sasidharan, Department of Radiation Oncology, Dr. Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India. Tel: 0416-228-2046; Mobile: +919626262296. E-mail: balunair@cmcvellore.ac.in
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Abstract

Background:

Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary gland cancer with high morbidity and mortality and poor response to treatment. The current options of treatment include radical surgery followed by radiotherapy (RT) with or without chemotherapy. The aim of this study was to analyse the patterns of recurrences, possible predictors of outcome and role of RT in a cohort of patients with non-metastatic SDC.

Methods:

A retrospective review of patients treated between 2010 and 2019 with histologically proven non-metastatic SDC was conducted.

Results:

Sixteen patients were included in the series. Median follow-up was 25 months. Progression-free survival (PFS) and overall survival (OS) at 12 months were 61% and 80%, respectively. Seven out of the 16 patients had disease progression, distant metastases being most frequent. Four patients died due to disease progression. PFS was significantly worse for patients with pathological neck node positivity (p = 0·036) and peri-parotid nodes (p = 0·007). Local control was significantly associated with RT (p = 0·011). Addition of any chemotherapy, regardless of either concurrent or adjuvant, had no impact on the PFS or OS. Pathological neck node positivity with nodal stage of N2 or higher correlated significantly with worse OS (p = 0·031).

Conclusion:

Salivary ductal carcinoma is an aggressive malignancy with high metastatic potential. Inferior prognosis was observed among patients who had metastatic deposits in either cervical nodes or peri-parotid nodes on histopathology. As systemic failures are more predominant among these patients, larger prospective trials are needed to formulate an optimum strategy for choice and sequencing of first-line systemic therapy.

Keywords

adjuvant therapyradiotherapyretrospectivesalivary duct carcinomasalivary gland cancer
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 335 - 342
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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