Low-grade stage II tumors of the salivary gland may be cured with surgery alone.[1,2,3] Radiation therapy as primary treatment may be used for tumors for which resection involves a significant cosmetic or functional deficit or as an adjuvant to surgery when positive margins are present.
High-grade stage II salivary gland tumors that are confined to the gland in which they arise may be cured by surgery alone, though adjuvant radiation therapy may be used, especially if positive margins are present. Primary radiation therapy may be given for tumors that are inoperable, unresectable, or recurrent. Fast neutron-beam radiation therapy has been shown to improve disease-free survival and overall survival in this clinical situation.[5,6,7]
Caregivers need help and emotional support.
A caregiver responds in his or her own way to the cancer patient's diagnosis and prognosis. The caregiver may feel emotions that are as strong as or stronger than those felt by the patient. The caregiver's need for information, help, and support is different from what is needed by the patient.
The life of a family caregiver changes in many ways when cancer is diagnosed. These changes affect most parts of life and continue after treatment ends.
Surgery alone or with postoperative radiation therapy, if indicated, is appropriate.[8,9]
Chemotherapy should be considered in special circumstances, such as when radiation therapy or surgery is refused.
Standard treatment options:
Localized high-grade salivary gland tumors that are confined to the gland in which they arise may be cured by radical surgery alone.
Postoperative radiation therapy may improve local control and increase survival rates for patients with high-grade tumors, positive surgical margins, or perineural invasion.[Level of evidence: 3iiiDii][11,12,13]
Fast neutron-beam radiation therapy or accelerated hyperfractionated photon-beam schedules reportedly are more effective than conventional x-ray therapy in the treatment of patients with inoperable, unresectable, or recurrent malignant salivary gland tumors.[5,6,7,14]
Treatment options under clinical evaluation:
Clinical trials exploring ways to improve local control with radiation therapy and/or radiosensitizers are appropriate. The role of chemotherapy is also under study.[15,16]
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II salivary gland cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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Mendenhall WM, Morris CG, Amdur RJ, et al.: Radiotherapy alone or combined with surgery for salivary gland carcinoma. Cancer 103 (12): 2544-50, 2005.
Chen AM, Granchi PJ, Garcia J, et al.: Local-regional recurrence after surgery without postoperative irradiation for carcinomas of the major salivary glands: implications for adjuvant therapy. Int J Radiat Oncol Biol Phys 67 (4): 982-7, 2007.
Wang CC, Goodman M: Photon irradiation of unresectable carcinomas of salivary glands. Int J Radiat Oncol Biol Phys 21 (3): 569-76, 1991.