Recurrent pleomorphic adenoma of the parotid gland: long-term outcome of patients treated with radiation therapy.
OBJECTIVE
To evaluate the role of radiation therapy in the management of recurrent pleomorphic adenoma of the parotid gland.


METHODS
Between 1960 and 2004, 34 patients were treated with postoperative radiation therapy for recurrent pleomorphic adenoma of the parotid gland to a median dose of 5000 cGy (range, 4,500-6,000 cGy). Median age was 48 years (range, 24-72 years). Gross total resection at the time of surgery before radiation was achieved in 30 patients (88%), and histologic analysis demonstrated multifocal disease in 16 patients (47%). Radiation was delivered for a first, second, third, fourth, fifth, and sixth local recurrence in 24%, 21%, 24%, 24%, 6%, and 3% of patients, respectively.


RESULTS
With a median follow-up of 17.4 years (range, 2.3-28.9 years), 2 patients had local recurrences at a median of 3.4 years after completion of radiation. The 20-year actuarial local control rate was 94%. One patient developed a second malignancy at approximately 14 years after completion of therapy.


CONCLUSIONS
The use of postoperative radiation therapy leads to excellent long-term local control for the treatment of recurrent pleomorphic adenoma with acceptable late toxicity. Although the incidence of second malignancy was low in this population, continued follow-up is warranted.
Chen
Allen M
AM
Department of Radiation Oncology, University of California, San Francisco (UCSF) Comprehensive Cancer Center, San Francisco, CA 94143-1708, USA. achen@radonc17.ucsf.edu
Garcia
Joaquin
J
Bucci
M Kara
MK
Quivey
Jeanne M
JM
Eisele
David W
DW
D000236:Adenoma / Q000532:radiotherapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000532:radiotherapy* / Q000601:surgery; D010307:Parotid Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011379:Prognosis; D016896:Treatment Outcome