Radiation-induced toxicities and outcomes after radiotherapy are independent of patient age in elderly salivary gland cancer patients: results from a matched-pair analysis of a rare disease

Rühle, Alexander; Rothhaar, Sofie; Haehl, Erik; Kalckreuth, Tobias; Sprave, Tanja; Stoian, Raluca; Zamboglou, Constantinos; Gkika, Eleni; Knopf, Andreas; Grosu, Anca‐Ligia; Nicolay, Nils H.

doi:10.1007/s00405-020-06393-x

Cited by 4 publications

(1 citation statement)

References 46 publications

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“…Studies focused on target volume selection, delineation, and dose level as a function of patient age/comorbidities are currently lacking. A study compared a small cohort of 29 elderly patients with major SGCs treated with chemo-radiotherapy or PORT with a matched-pair group of younger patients, without finding any difference in acute or late toxicities (90). In RT for mucosal SCC, age was not reported as a prognostic factor for the development of acute or late toxicity, therefore it is recommended to follow similar guidelines for SGCs RT in elderly as in younger patients (91), also considering that irradiated volumes are typically smaller for SGCs in comparison to other HNCs.…”

Section: Radiation Therapy With Photons In the Elderlymentioning

confidence: 99%

Salivary gland cancers in elderly patients: challenges and therapeutic strategies

Colombo

Lierde²,

Zlate³

et al. 2022

Front. Oncol.

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Salivary gland carcinomas (SGCs) are the most heterogeneous subgroup of head and neck malignant tumors, accounting for more than 20 subtypes. The median age of SGC diagnosis is expected to rise in the following decades, leading to crucial clinical challenges in geriatric oncology. Elderly patients, in comparison with patients aged below 65 years, are generally considered less amenable to receiving state-of-the-art curative treatments for localized disease, such as surgery and radiation/particle therapy. In the advanced setting, chemotherapy regimens are often dampened by the consideration of cardiovascular and renal comorbidities. Nevertheless, the elderly population encompasses a broad spectrum of functionalities. In the last decades, some screening tools (e.g. the G8 questionnaire) have been developed to identify those subjects who should receive a multidimensional geriatric assessment, to answer the question about the feasibility of complex treatments. In the present article, we discuss the most frequent SGC histologies diagnosed in the elderly population and the relative 5-years survival outcomes based on the most recent data from the Surveillance, Epidemiology, and End Results (SEER) Program. Moreover, we review the therapeutic strategies currently available for locoregionally advanced and metastatic disease, taking into account the recent advances in precision oncology. The synergy between the Multidisciplinary Tumor Board and the Geriatrician aims to shape the most appropriate treatment pathway for each elderly patient, focusing on global functionality instead of the sole chronological age.

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Section: Radiation Therapy With Photons In the Elderlymentioning

confidence: 99%

Salivary gland cancers in elderly patients: challenges and therapeutic strategies

Colombo

Lierde²,

Zlate³

et al. 2022

Front. Oncol.

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High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases

Freitag

Lettmaier

Semrau

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Salivary Gland cancer (SGC) is a rare and heterogenous group of tumors. Standard therapeutic options achieve high local but poor distant control rates, especially in high-grade SGC. The aim of this monocentric study was to evaluate patterns of recurrence and its treatment options (local ablative vs. systemic) in a homogenously treated patient population with high-grade SGC after surgery and radio(chemo)therapy. Methods Monocentric, retrospective study of patients with newly diagnosed high-grade salivary gland cancer. We retrospectively reviewed clinical reports from 69 patients with high-grade salivary gland cancer in a single-center audit. Survival rates were calculated using the Kaplan–Meier method and prognostic variables were analyzed (univariate analysis: log-rank test; multivariate analysis: Cox regression analysis). Results The median time of follow-up was 31 months. After 5 years, the cumulative overall survival was 65.2%, cumulative incidence of local recurrence was 7.2%, whereas the cumulative incidence of distant metastases was 43.5% after 5 years. 30 of 69 patients developed distant metastases during the time of follow-up, especially patients with adenoid cystic carcinoma, salivary duct carcinoma, adenocarcinoma NOS and acinic cell carcinoma with high-grade transformation. The most common type of therapy therefore was chemotherapy (50%). 85.7% of patients with local ablative therapy of distant metastases show disease progression during follow-up afterwards. Conclusion With surgery and radio-chemotherapy, a high rate of loco-regional control is reached, but over 40% of patients develop distant metastases in the further follow-up which usually present a diffuse pattern involving in a diffuse metastases. Therefore, in the future, intensified interdisciplinary combination therapies even in the first-line treatment in certain subtypes of high-grade SGC should be investigated.

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Treatment outcomes of elderly salivary gland cancer patients undergoing radiotherapy – Results from a large multicenter analysis

Akbaba

Rühle

Rothhaar

et al. 2021

Radiotherapy and Oncology

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Radiation-induced toxicities and outcomes after radiotherapy are independent of patient age in elderly salivary gland cancer patients: results from a matched-pair analysis of a rare disease

Cited by 4 publications

References 46 publications

Salivary gland cancers in elderly patients: challenges and therapeutic strategies

Salivary gland cancers in elderly patients: challenges and therapeutic strategies

High-grade salivary gland cancer: is surgery followed by radiotherapy an adequate treatment to reach tumor control? Results from a tertiary referral centre focussing on incidence and management of distant metastases

Treatment outcomes of elderly salivary gland cancer patients undergoing radiotherapy – Results from a large multicenter analysis

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