title: Postoperative radiation therapy for parotid pleomorphic adenoma with close or positive margins: treatment outcomes and toxicities.
abstract: OBJECTIVE
  To evaluate the locoregional control and treatment toxicity of patients with pleomorphic adenoma after resection with close or positive margins followed by postoperative radiation therapy (PORT).
  
  
  METHODS
  Between 2002 and 2011, twenty-one patients underwent PORT at the Mount Sinai Beth Israel Medical Center for pleomorphic adenoma of the parotid with close or positive margins. Four out of the 21 patients (19%) had recurrent lesions. The median dose was 57.6 Gy (range 55.8-69.96) delivered at 1.8-2.12 Gy/fraction. Treatment and follow-up data were retrospectively analyzed for locoregional control as well as acute- and late-treatment toxicities. Actuarial survival analysis was also performed.
  
  
  RESULTS
  Twelve women and 9 men with a median age of 46 (26-65) at PORT were included in this study. Eighty-one percent of the cohort had positive resection margins while 19% had close margins. At a median follow-up of 92 months, 19/21 patients (90%) had locoregional control. Two patients who failed had primary lesions which recurred locally, and initially had positive margins. The two recurrences occurred at 8 months and 12 months. Acute Radiation Therapy Oncology Group (RTOG) grade 1 and 2 toxicities were experienced by 11 (52%) and 4 (19%) patients, respectively, while 2 (10%) experienced late RTOG grade 1 toxicities. No patients experienced any grade 2-4 late toxicities. Actuarial survival was 100%.
  
  
  CONCLUSIONS
  PORT for patients with pleomorphic adenoma of the parotid gland after resection with close or positive margins results in excellent locoregional control and low treatment-related morbidity.
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A. Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, U.S.A.
authors: Shyamal
authors: S
authors: Patel
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A. Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, U.S.A. Waleed246@gmail.com.
authors: Waleed F
authors: WF
authors: Mourad
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A. Department of Radiation Oncology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Chengtao
authors: C
authors: Wang
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Bhaswant
authors: B
authors: Dhanireddy
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Catherine
authors: C
authors: Concert
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Magdalena
authors: M
authors: Ryniak
authors: Department of Radiology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Azita S
authors: AS
authors: Khorsandi
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Rania A
authors: RA
authors: Shourbaji
authors: Department of Medical Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Zujun
authors: Z
authors: Li
authors: Department of Medical Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Bruce
authors: B
authors: Culliney
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Rajal
authors: R
authors: Patel
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Richard L
authors: RL
authors: Bakst
authors: Department of Otolaryngology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Theresa
authors: T
authors: Tran
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Daniel
authors: D
authors: Shasha
authors: Department of Otolaryngology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Stimson
authors: S
authors: Schantz
authors: Department of Otolaryngology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Mark S
authors: MS
authors: Persky
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Kenneth S
authors: KS
authors: Hu
authors: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, New York, NY, U.S.A.
authors: Louis B
authors: LB
authors: Harrison
mesh_terms: D008949:Adenoma, Pleomorphic / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: Postoperative radiation; benign; close margins; local control; parotid; pleomorphic adenoma; positive margins; postoperative radiotherapy; radiation toxicity