title: A rationale for chemoradiation (vs radiotherapy) in salivary gland cancers? On behalf of the REFCOR (French rare head and neck cancer network).
abstract: BACKGROUND
  Salivary gland carcinomas constitute a heterogeneous group of tumors, with over 20 histological subtypes of various prognoses. The mainstay of treatment is surgery, with radiotherapy advocated for unresectable disease or postoperatively in case of poor prognostic factors such as high grade, locally advanced and/or incompletely resected tumors. Concurrent chemotherapy is sometimes advocated in routine practice based on criteria extrapolated from squamous cell carcinomas of the head and neck, on radioresistance of salivary gland tumors and on results obtained in the metastatic setting. The aim of this review was to identify situations where chemotherapy is advocated.
  
  
  METHODS
  A search of literature was performed with the following key words: parotid, salivary gland, neoplasm, cancer, malignant tumor, chemoradiation, chemotherapy, radiotherapy and treatment. Case report and studies published before 2000 were not included.
  
  
  RESULTS
  Platinum-based regimens were the most frequent. Other regimens were reported and seemed dependent on histology. The level of evidence for the concurrent delivery of chemotherapy with radiation therapy is supported by a low level of evidence. Prescribing chemotherapy mostly relies on poor prognostic factors similar to those used to indicate high dose radiotherapy. Protocols vary with histology.
  
  
  CONCLUSIONS
  The rationale for adding chemotherapy to radiotherapy remains to be demonstrated prospectively. Although the type of systemic treatments used may be adapted on histology, the strongest rationale remains in favor of cisplatin.
authors.affiliation: Radiation Oncology, CHRU, Besancon 25030, France; CHBM, Montbéliard 25209, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cerda
authors.affiliation: Radiation Oncology, CHRU, Besancon 25030, France; CHBM, Montbéliard 25209, France.
authors.forename: Xu Shan
authors.initials: XS
authors.lastname: Sun
authors.affiliation: Medical Oncology, APHP CHU Pitié Salpétrière, Paris75013, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Vignot
authors.affiliation: Radiology, Centre Antoine Lacassagne, Nice 06189 France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marcy
authors.affiliation: Head and Neck Surgery, APHP CHU Tenon, Paris 75020, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Baujat
authors.affiliation: Pathology, Institut Gustave Roussy, Villejuif 94000, France.
authors.forename: Anne-Catherine
authors.initials: AC
authors.lastname: Baglin
authors.affiliation: Clinical Oncology, Faculty of Medicine, Sohag University, Egypt.
authors.forename: Ali Mohamed
authors.initials: AM
authors.lastname: Ali
authors.affiliation: Maxillo-Facial Surgery, CHU d'Amiens, 80000 France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Testelin
authors.affiliation: Head and Neck Surgery, CHU de Grenoble, 38000 France.
authors.forename: Emile
authors.initials: E
authors.lastname: Reyt
authors.affiliation: Head and Neck Surgery, Institut Gustave Roussy, Villejuif 94000, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Janot
authors.affiliation: Radiation Oncology, Centre Antoine Lacassagne, Nice 06200, France. Electronic address: jthariat@hotmail.com.
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000379:methods; D006801:Humans; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D012468:Salivary Gland Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D012469:Salivary Glands / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents
keywords: Adenoid cystic carcinoma; Cancer; Chemotherapy; Histology; Radiation therapy; Rare; Salivary gland; Survival