Abstract
Myoepithelial carcinoma (MC) is an extremely rare form of tumor, with no standard treatment established to date. Although several reports have discussed postoperative radiation therapy (PORT), few have applied intensity-modulated radiation therapy (IMRT), and none has described the dose and radiation field in detail. In this report, we describe a case of MC of the parotid gland that was treated with high-dose IMRT (70 Gy) after partial resection. The patient, a 61-year-old female, underwent excisional surgery and was diagnosed with MC arising from a pleomorphic adenoma (PA). Postoperative irradiation was administered as 70 Gy in 35 fractions of local radiation. The patient had cancer recurrence in the irradiated field. However, no serious adverse events associated with the radiation therapy have been confirmed, implying that postoperative high-dose radiation therapy may be safely administered via IMRT.
Highlights
Myoepithelial carcinoma (MC) is an extremely rare form of tumor that accounts for only approximately 1% of parotid carcinomas [1]
Some reports have discussed the application of postoperative Radiation therapy (RT) (PORT) for MC [5-10], few have described intensity-modulated RT (IMRT), and none has described the dose and radiation field in detail
We present a case in which high-dose IMRT (70 Gy) was administered to a patient following MC resection in the parotid gland
Summary
Myoepithelial carcinoma (MC) is an extremely rare form of tumor that accounts for only approximately 1% of parotid carcinomas [1]. Radiation therapy (RT) is an important postsurgical adjuvant therapy; its efficacy for MC is debatable, and adverse events must be avoided In this context, intensity-modulated RT (IMRT), which has been widely applied in recent years, may be an appropriate form of treatment [3,4]. Contours were developed using preoperative imaging (CT, MRI, and fluorodeoxyglucose positron emission tomography/CT) findings and the in situ contralateral parotid as a guide to contour a dummy structure representing the removed parotid gland and tumor (old GTV). This structure was expanded by 0.5 and 2 cm into the surrounding soft tissue to attain the clinical target volumes (CTV1 and CTV2, respectively). No other severe (≥G2) adverse events (e.g., facial nerve paralysis and auditory impairment) were observed
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