title: Postoperative radiotherapy in patients with salivary duct carcinoma: clinical outcomes and prognostic factors.
abstract: This study sought to investigate the clinical outcome and the role of postoperative radiotherapy for patients with salivary duct carcinoma (SDC) who had undergone surgery and postoperative radiotherapy. We performed a retrospective analysis of 25 SDC patients treated between 1998 and 2011 with surgery and postoperative radiotherapy. The median prescribed dose was 60 Gy (range, 49.5-61.4 Gy). The clinical target volume (CTV) was defined as the tumor bed in four patients, the tumor bed and ipsilateral neck in 14 patients, and the tumor bed and bilateral neck in six patients. Local control (LC), disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and prognostic variables were analyzed with the log-rank test. The 5-year LC, DFS and OS were 67%, 45% and 47%, respectively. Disease recurrence was found in 12 patients: seven as local, four as regional and eight as distant failure. Perineural and lymphovascular invasion was a significant prognostic factor for LC (P = 0.03). Local failure was common, and the presence of local recurrence significantly affected the OS (P < 0.05). We conclude that surgery and postoperative radiotherapy is expected to decrease the risk of local failure and contribute to good prognoses for patients with SDC. It might be advisable to have the CTV include the cranial nerves involved and the corresponding parts of the skull base in cases of pathologically positive perineural invasion.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Torahiko
authors.initials: T
authors.lastname: Nakashima
authors.forename: Naonobu
authors.initials: N
authors.lastname: Kunitake
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Higaki
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Saiji
authors.initials: S
authors.lastname: Ohga
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Yoshitake
authors.forename: Kayoko
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Kaori
authors.initials: K
authors.lastname: Asai
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000401:mortality*; D011182:Postoperative Care / Q000401:mortality; D018714:Radiotherapy, Adjuvant / Q000401:mortality*; D020266:Radiotherapy, Conformal / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment; D018987:Salivary Ducts / Q000528:radiation effects* / Q000601:surgery*; D012468:Salivary Gland Neoplasms / Q000401:mortality* / Q000628:therapy*; D015996:Survival Rate
keywords: perinerual invasion; postoperative radiotherapy; salivary duct caricnoma
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