title: Management algorithm for HIV-associated parotid lymphoepithelial cysts.
abstract: We report an evidence-based management algorithm for benign lymphoepithelial cysts (BLEC) of the parotid glands in HIV patients based on long-term outcomes after radiation therapy. From 1987 to 2013, 72 HIV-positive patients with BLEC of the parotid glands treated at our institutions were identified and their medical records were reviewed and analyzed. The primary endpoint of our study was to determine a dose response in HIV patients with BLEC. In group A (≤18 Gy), which received a median dose of 10 Gy (8-18), overall response (OvR), complete response (CR), partial response (PR), and local failure (LF) was experienced by 7, 7, 0, and 93 %, respectively. In group B (≥22.5 Gy), which received a median dose of 24 Gy (22.5-30), OvR, CR, PR, and LF was experienced by 88, 65, 23, and 12 %. Logistic regression revealed that higher dose (≥22.5 Gy) predicted for cosmetic control (p = 0.0003). Multiple regression analysis revealed higher dose predicted for cosmetic control (p = 0.0001) after adjusting for confounding variables (age, gender, race, HAART use, BLEC duration, and fractionation size). No patients in either group experienced RTOG grade ≥3 toxicities. A radiation dose of 24 Gy delivered in 12-16 fractions of 1.5-2 Gy per fraction provides long-term cosmetic control in HIV-positive patients with BLEC of the parotid glands.
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA. Waleed246@gmail.com.|Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA. Waleed246@gmail.com.
authors.forename: Waleed F
authors.initials: WF
authors.lastname: Mourad
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.|Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Shyamal
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Young
authors.affiliation: Department of Radiology, Mount Sinai Beth Israel Medical Center, New York, NY, USA.
authors.forename: Azita S
authors.initials: AS
authors.lastname: Khorsandi
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Concert
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Rania A
authors.initials: RA
authors.lastname: Shourbaji
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Ciarrocca
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Bakst
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shasha
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Chandan
authors.initials: C
authors.lastname: Guha
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Madhur K
authors.initials: MK
authors.lastname: Garg
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Hu
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Shalom
authors.initials: S
authors.lastname: Kalnicki
authors.affiliation: Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA.
authors.forename: Louis B
authors.initials: LB
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D019583:Dose Fractionation, Radiation; D004814:Epidermal Cyst / Q000532:radiotherapy* / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000532:radiotherapy* / Q000821:virology*; D012189:Retrospective Studies
keywords: AIDS; Benign lymphoepithelial cysts; HAART; HIV; Parotid gland; Radiation therapy