25-year follow-up of HIV-positive patients with benign lymphoepithelial cysts of the parotid glands: a retrospective review.
OBJECTIVE
To report long-term outcomes for HIV-positive patients who underwent radiation therapy (RT) for benign lymphoepithelial cysts (BLEC) of the parotid glands.


METHODS
In this single institution retrospective study of HIV-associated BLEC of the parotids, the medical records of 37 HIV-positive patients who were treated with RT between 1987-2012 were reviewed. Patients were stratified into two groups; group A consisted of 15 patients (40.5%) who received a total dose of ≤18Gy, with a median dose 10 Gy (range 8-18Gy), and group B consisted of 22 patients (59.5%) who received a total dose of 24 Gy. In addition to dosing information, additional patient data were collected, including demographics, HAART compliance, follow-up, and re-treatment status.


RESULTS
The median age at the time of treatment was 41 (range=7-70) years. With a median follow-up of 35 (range=12-75) months for the entire cohort, the complete response (CR) and partial response (PR) rates were 35% and 8%, respectively. All but one of 15 patients in Group A (lower total dose) eventually experienced local failure with the re-emergence of parotid hypertrophy. Among the patients in group B (higher total dose of 24 Gy), 55%, 13%, and 32% experienced CR, PR, and LF, respectively. Median times to failure in groups A and B were 7 and 20 months, respectively (p<0.0001). Similarly, logistic regression test revealed the higher dose to be associated with better response rate (i.e. CR or PR) (p<0.0001), which was also statistically significant (p=0.03) after adjusting for confounding variables (age, race, gender, HAART use, and fractionation).


CONCLUSIONS
A total dose of 24 Gy continues to be recommended for durable cosmetic control of BLEC of the parotid glands that is associated with HIV-seropositivity.
M.D., Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E210th Street, Bronx, NY, 10467. waleed246@gmail.com.
Waleed F
WF
Mourad
Rebekah
R
Young
Rafi
R
Kabarriti
Dukagjin M
DM
Blakaj
Rania A
RA
Shourbaji
Jonathan
J
Glanzman
Shyamal
S
Patel
Nitin
N
Ohri
Ravindra
R
Yaparpalvi
Jonathan J
JJ
Beitler
Shalom
S
Kalnicki
Madhur K
MK
Garg
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004848:Epithelium / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000472:pathogenicity; D015658:HIV Infections / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008210:Lymphocele / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D008221:Lymphoid Tissue / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D010306:Parotid Gland / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
HIV positive; Radiation therapy (RT); benign lymphoepitheilial cysts (BLEC); highly active antiretroviral therapy (HAART); parotid gland hyperplasia