Treatment of Parotid Non-Hodgkin Lymphoma: A Meta-Analysis

Abstract

PurposeThis meta-analysis aimed to review the published outcomes of parotid non-Hodgkin lymphoma (NHL) pertaining to different treatment modalities.Materials and MethodsA total of 48 journal articles published between 1993 and 2015, comprising 742 cases of parotid NHL, were initially evaluated. In total, 108 patients from 12 studies who had sufficient data for analysis, including age, tumor histopathology, treatment modality, and outcome at final follow-up, were included. Patients were randomly assigned to different categories on the basis of histopathology and treatment modality. Groups were compared using Kaplan-Meier survival curve analysis and the Mann-Whitney U test.ResultsLog-rank tests demonstrated that for early-stage (I and II) parotid NHL of all histopathology variants, radiation therapy significantly improved the survival rate versus chemotherapy (P = .043), as well as combined treatment with chemotherapy and radiation therapy (P = .023). For early-stage diffuse large B-cell lymphoma, combined treatment significantly improved survival versus single treatment (P = .028). No treatment was received by seven patients with early-stage mucosa-associated lymphoid tissue lymphoma after undergoing parotidectomy. When the clinical outcomes of these patients were compared with those of other patients with the same histology who underwent further treatment, no significant differences were noted in survival outcomes.ConclusionRadiation therapy seems to be a valid treatment of early-stage parotid NHL. However, for diffuse large B-cell lymphoma, survival was higher with combined treatment versus single treatment. For early-stage parotid mucosa-associated lymphoid tissue lymphoma, complete excision of the tumor through superficial parotidectomy may have similar survival outcome.

A Primary Parotid Mucosa-Associated Lymphoid Tissue Non-Hodgkin Lymphoma in a Patient With Sjogren Syndrome

“…The studies have suggested that in lowstage MALT lymphoma of the parotid, chemotherapy alone results in similar outcomes to those of radiation therapy alone. However, in more aggressive subtypes such as diffuse large B-cell lymphoma, a combination of chemotherapy and radiation therapy is usually recommended [18]. Our case offers a clear example of a patient for whom radiological studies, considered in the context of her past medical history, and confirmed by pathologic analysis, avoided unnecessary surgery in the management of her parotid gland neoplasm.…”

Lymphoma of the Lacrimal Gland — An International Multicenter Retrospective Study

“…6 However, with the large number of cases in this present study, the distribution of lymphoma subtypes resembles the distributions reported in the orbit and OA rather than that of the salivary glands. 4,[11][12][13][14][15] The distribution of lymphoma subtypes differed between eye cancer centers. The center in Hyderabad had a markedly higher proportion of patients with EMZL (84%) than the remaining eye cancer centers (43%-61 %), while the Copenhagen Center, which is a national eye cancer center, had a noticeably high proportion of MCL (23%) (Table 1).…”

Mantle cell lymphoma, malt lymphoma, small lymphocytic lymphoma, and follicular lymphoma of the oral cavity: An update

“…Only 22 cases reported stage at diagnosis, with 21 cases at initial stages (I/II). Advanced stages represented 4.5% ( Table 1 ) , which is lower than in major salivary glands, where 23% of cases were previously diagnosed in stages III or IV 28 …”