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6.4.10: 10. Postoperative Radiation Therapy

  • Page ID
    18331
  • High risk requiring radiotherapy

    Primary tumour bed for malignancy

    • High grade primary salivary malignancy
    • High grade mucoepidermoid
    • Salivary duct carcinoma
    • Ca ex pleomorphic
    • Adenoid cystic
    • Adenocarcinoma NOS
    • T3/4 (>4cms)
    • Perineural involvement
    • Lymphovascular invasion
    • Positive margin / close margin / tumour peeled off nerve
    • Extra-parenchymal extension
    • Recurrent disease
    • Intraoperative tumour spillage
    • Previous open / incision biopsy

    Neck

    • Undissected N0 neck
    • T3/4
    • Skin/conjunctival cancer metastases to parotid
    • Dissected neck
    • >2 metastases
    • ECS

    Low risk not requiring radiotherapy

    Malignant

    • Low grade primary salivary malignancy, completely excised
    • <4cms diameter

    Benign

    • Benign tumour peeled off nerve in a well defined surgical dissection plane
    • Controlled intraoperative tumour spillage of benign tumour, with copious irrigation of the wound

    Chemotherapy in the absence of radiation therapy? Current evidence does not support use of chemotherapy for salivary cancers with either curative or palliative intent. (Vander Poorten V, Meulemans J, Delaere P et al. Molecular Markers and Chemotherapy for Advanced Salivary Cancer. Curr Otorhinolaryngol Rep (2014) 2: 85. https://doi.org/10.1007/s40136-014-0040-2)

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