Stereotactic Radiation for Palliation of Skull Base Recurrences of Salivary Gland Carcinomas: Implications for Tumor Targeting.
BackgroundApproximately 3 to 13% of salivary carcinomas recur at the skull base. We report our experience treating these recurrences with stereotactic radiation.MethodsIn total, 14 patients with skull base recurrence of salivary gland carcinoma were identified. Patient characteristics, treatment parameters, response to treatment, local recurrence-free/overall survival, and patterns of failure were studied.ResultsAll 12 symptomatic patients experienced palliation of symptoms. Two grade 3 toxicities were observed. Local recurrence-free survival after skull base treatment was 28 months (74 months after allowing for additional course of salvage radiotherapy). Overall survival was 153 months from primary diagnosis and 67 months from first skull base failure. Of 13 treatment failures, 8 occurred at margins; the rest were infield. All intracranial failures occurred along meningeal surfaces.ConclusionsStereotactic radiation provides well-tolerated palliation for the majority of patients, but with a high rate of local failure. Due to the propensity for meningeal failures, we suggest increasing margins along the meningeal surfaces when treating these patients.
Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois, United States.
Zaid A
ZA
Siddiqui
Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois, United States; Department of Neurological Surgery, Loyola University Medical Center Maywood, Illinois, United States.
Edward
E
Melian
Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois, United States.
Anil
A
Sethi
Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois, United States; Department of Neurological Surgery, Loyola University Medical Center Maywood, Illinois, United States.
Vikram C
VC
Prabhu
Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois, United States.
Iris
I
Rusu
Department of Radiation Oncology, Loyola University Medical Center, Maywood, Illinois, United States.
Bahman
B
Emami
Department of Otolaryngology, Loyola University Medical Center Maywood, Illinois, United States.
John P
JP
Leonetti
Department of Neurological Surgery, Loyola University Medical Center Maywood, Illinois, United States.
Douglas E
DE
Anderson
palliation; radiosurgery; salivary gland carcinoma; skull base recurrence; stereotactic radiation