Treatment Of Salivary Gland Tumors Research Articles

The tumor microenvironment of benign and malignant salivary gland tumors.

Treatment of salivary gland tumors (SGTs) remains challenging. Little is known about the immune landscape of SGTs. We aimed to characterize the tumor microenvironment in benign and malignant SGTs. Eleven benign and nine malignant tumors were collected from patients undergoing curative intent surgery. Specimens were analyzed using mass cytometry by time-of-flight. Immune cell populations were manually gated, and T cells were clustered using the FlowSOM algorithm. Population frequencies were compared between high-grade and low-grade malignancies, corrected for multiple hypothesis testing. There were trends towards increased CD4+ and CD8+ T cells among malignant tumors. High-grade malignancies exhibited trends towards higher frequencies of CD8+ PD-1+ CD39+ CD103+ exhausted T cells, CD4+ FoxP3+ TCF-1+ CD127- Tregs, and CD69+ CD25- CD4+ T cells compared to low-grade malignancies. SGTs exhibit significant immunologic diversity. High-grade malignancies tended to have greater infiltration of exhausted CD8+ T cells and Tregs, which may guide future studies for immunotherapy strategies.

Diagnostic performance of inflammatory biomarkers and cytological analysis in salivary gland tumors.

This study aimed to evaluate the diagnostic performance of serum inflammatory biomarkers in salivary gland tumors with dubious results following cytological analysis. A retrospective analysis of 239 cases following surgery between January 2011 and June 2022 was performed. Receiver Operating Characteristic curves were drawn and areas under the curves were computed to evaluate the diagnostic performance of the inflammatory biomarkers (SII, SIRI, PLR, and NLR). Optimal cut-offs for each marker were determined by maximizing the Youden index. Analysis showed that among the major biomarkers examined, SIRI performed an AUC of 0.77. The best SIRI cut-off was 0.94 with an accuracy of 79.9%. The accuracy, sensitivity, and specificity of cytological analysis were 77.8%, 59.6%, and 90.7% respectively. By combining SIRI with cytological analysis we demonstrated an increase in sensitivity to 82.8%. Inflammatory biomarkers could be evaluated to support the diagnosis and treatment of salivary gland tumors in difficult cases.

Pattern of Salivary Gland Tumours among Patients Attending Otorhinolaryngology and Maxillofacial Services at Tertiary Hospital in Tanzania, A Cross-Sectional Study

The proportion of neoplasms of the salivary gland in the study population accounted for 10% of all head & neck and 3% of all neoplasms in the body. There is a scarcity of information regarding salivary gland tumours in Tanzania; therefore, this study addresses important issues in prevalence, histological, demographic characteristics, co-morbidities and treatment of salivary gland tumours. This study aimed to determine the pattern of salivary gland tumours among patients attending Otorhinolaryngology and Maxillofacial services at a tertiary hospital. This was a cross-sectional study done on patients diagnosed with salivary gland tumours. A total of 276 patients were recruited. Pre-tested coded questionnaires were used to collect data which were later analysed using SPSS statistical computer software version 20.0. Of the studied 276 participants, 156 (56.5%) were males, and 120 (43.5%) were females. Their age group ranged between 0 to 90 years with a mean age of 49.47 years, SD ±15.7. Most of them, 69 (28.6 %) aged above 60 years, and 31 (26.1 %) were in the age group of 40-49 and 60+ years. Mostly affected were males, 64 (55.1%) and 52 (44.8%) were females, P=0.76. The most commonly affected site was the parotid gland (75%), and the least affected sites were submandibular and sublingual (7.5%). Among 116 patients, malignant and benign types accounted for 76 (66%) and 40 (34%), respectively. Both benign and malignant salivary gland tumours (SGT) had male preponderance. Pleomorphic adenoma was high in males (28.1%) compared to females (25.0%); mucoepidermoid carcinoma was commonly found, accounting for 23.4% in males and 28.9% in females. More males were commonly affected, particularly the 40-49 age group, although the differences were statistically insignificant (p-value= 0.07). In conclusion, the majority of salivary gland tumours were malignant type and mucoepidermoid carcinoma being the most common histological type, while pleomorphic adenoma was the most frequently encountered benign type, and both had male preponderance, mostly seen at the age of 40 years and above. The majority of patients with malignant tumours presented late to the hospital; therefore, there is a need for advocacy for early health-seeking behaviour to the community and early detection of the disease by health personnel in the primary health centres.

The Chaperone System in Salivary Glands: Hsp90 Prospects for Differential Diagnosis and Treatment of Malignant Tumors.

Salivary gland tumors represent a serious medical problem and new tools for differential diagnosis and patient monitoring are needed. Here, we present data and discuss the potential of molecular chaperones as biomarkers and therapeutic targets, focusing on Hsp10 and Hsp90. The salivary glands are key physiological elements but, unfortunately, the information and the means available for the management of their pathologies, including cancer, are scarce. Progress in the study of carcinogenesis has occurred on various fronts lately, one of which has been the identification of the chaperone system (CS) as a physiological system with presence in all cells and tissues (including the salivary glands) that plays a role in tumor-cell biology. The chief components of the CS are the molecular chaperones, some of which belong to families of evolutionarily related molecules named heat shock protein (Hsp). We are quantifying and mapping these molecular chaperones in salivary glands to determine their possible role in the carcinogenetic mechanisms in these glands and to assess their potential as diagnostic biomarkers and therapeutic targets. Here, we report recent findings on Hsp10 and Hsp90 and show that the quantitative and topographic patterns of tissue Hsp90 are distinctive of malignant tumors and differentiate benign from malignant lesions. The Hsp90 results show a correlation between quantity of chaperone and tumor progression, which in turn calls for negative chaperonotherapy, namely, elimination/inhibition of the chaperone to stop the tumor. We found that in vitro, the Hsp90 inhibitor Ganetespib is cytotoxic for the salivary gland UM-HACC-2A cell line. The drug, by interfering with the pro-survival NF-κB pathway, hampers cellular proliferation and migration, and favors apoptosis, and can, therefore, be considered a suitable candidate for future experimentation to develop a treatment for salivary gland tumors.

Increasing Trends in Mortality Rate Among Salivary Gland Tumors in Non-Geriatric African Americans.

BackgroundThe treatment of salivary gland tumors has not changed significantly in the past two decades. However, the increase in the geriatric population with these tumors poses a new challenge for their management. This study explores the incidence-based mortality trends in the geriatric and non-geriatric population for the time period of 2000 - 2014 and compares the trends between races.MethodsMortality data were extracted from the Surveillance, Epidemiology, and End Results (SEER) Database for the years 2000 - 2014. Incidence-based mortality for all stages of salivary gland tumors was queried and the results were grouped by age (geriatric vs. non-geriatric determined as 65 vs. below 65 years of age) and race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander). All stages and both genders were included in the analysis. T-test was used to determine statistically significant difference between various subgroups. Linearized trend lines were used to visualize the mortality trends between various subgroups (geriatric vs. non-geriatric and Caucasian vs. African American).ResultsIncidence-based mortality for salivary gland tumors has worsened since 2000 to 2014 for both geriatric and non-geriatric patients (P < 0.05). There was a statistically significant difference between these two groups in both Caucasian/White patients and African American/Black patients. Notably, the worst incidence-based mortality rates were noted in African American/Black non-geriatric patients followed by Caucasian/White non-geriatric patients. However, there was no statistical difference in incidence-based mortality between Caucasian/White patients and African American/Black geriatric patients.ConclusionsThe similarity in incidence-based mortality for geriatric patients with salivary gland tumors in both Caucasian/White patients and African American/Black groups suggests that the effects of race may not be pronounced in the elderly population. The high rate of incidence-based mortality in African American/Black non-geriatric patients may suggest environmental influence and warrants further study.

Postoperative Management of Salivary Gland Tumors.

Salivary gland tumors represent a heterogeneous group of neoplasms characterized by varied histologies and disease outcomes. Initial treatment for the primary and gross nodal disease is usually surgery. Management of the clinically node-negative neck depends upon the risk of lymph nodal involvement. This is usually determined by the AJCC "T" stage and histology. Both surgery and radiation may be utilized to address the lymph nodes at risk. This is especially important for minor salivary gland tumors. Radiation plays an important role in the adjuvant management of salivary gland tumors by reducing the risk of locoregional recurrence. Certain histologies like adenoid cystic carcinoma have a predilection for neurotropic spread to the skull base. Radiation is particularly important in controlling disease at the skull base. The role of concurrent chemotherapy in the adjuvant treatment of salivary gland tumors is not established and remains an area of active research. Certain histologies like salivary duct carcinoma exhibit readily identifiable molecular targets amenable to targeted therapy. Finally, advanced testing of these tumors using next-generation sequencing can also potentially identify molecular targets amenable to therapy. While useful in the management of metastatic disease, the role of these therapies in the adjuvant setting remains unknown.

Conservative and functional surgery in the treatment of salivary gland tumours

The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour. For salivary gland tumours, conservative and functional salivary surgery, including partial sialoadenectomy as well as anatomical and functional preservation of the facial nerve, great auricular nerve, superficial musculo-aponeurotic system (SMAS), and Stensen’s duct, has become increasingly popular. In the present review, we discuss the following aspects of conservative and functional surgery in the treatment of salivary gland tumours: (i) partial superficial parotidectomy (PP) to treat benign parotid gland tumours, (ii) modification of surgical incisions to improve cosmetic results, (iii) modification of the surgical approach to decrease complications, (iv) extracardial dissection to treat benign superficial parotid tumours, (v) partial sialoadenectomy to treat benign submandibular gland tumours, and (vi) 125I brachytherapy to preserve facial nerves. The majority of the operated parotid or submandibular glands are preserved, and surgical complications are also decreased. Conservative and functional surgery plays a significant role in maintaining normal salivary gland function and in improving patients’ quality of life during the treatment of salivary gland tumours and thus should be further promoted.

Comparison of mortality trends in geriatric and nongeriatric patients with salivary gland tumors.

e23026 Background: The treatment of salivary gland tumors has not changed significantly in the past two decades. However, its increased incidence in the geriatric population poses new challenges for their management. This study explores the incidence-based mortality (IBM) trends in the geriatric and non-geriatric population for the time period of 2000 to 2014 and compares the trends between races. Methods: Mortality data was extracted from the Surveillance, Epidemiology, and End Results (SEER) Database for the years 2000 to 2014. IBM for all stages of salivary gland tumors was queried and the results were grouped by age (geriatric vs. non-geriatric) and race (Caucasian/White, African American (AA)/Black, American Indian/Alaskan native and Asian/Pacific Islander). All stages and both genders were included in the analysis. T-test was used to determine statistically significance difference between various subgroups. Linearized trend lines were used to visualize the mortality trends between various subgroups (Geriatric vs. Non- geriatric and Caucasian vs. African American). Results: IBM for salivary gland tumors has worsened since 2000 to 2014 for both geriatric and non-geriatric patients (P &lt; 0.05), There was a statistically significant difference between these two groups in both Caucasian/White and AA/Black patients. Notably, the worst IBM rates were noted in non-geriatric AA/Black patients followed by non-geriatric Caucasian/White patients. However, there was no statistical difference in IBM between geriatric patients of Caucasian/White and AA/Black descent. Conclusions: The similarity in IBM for geriatric patients with salivary gland tumors in both Caucasian/White and AA/Black groups suggest that the effects of race may not be pronounced in the elderly population. The high rate of IBM in non-geriatric AA/Black patients may suggest environmental influence and warrants further study.

Precision oncology for the treatment of salivary gland tumors.

e17577 Background: Salivary gland tumors (SGT) represent a rare and heterogeneous group of malignancies. No standard treatment exists in the advanced situation and the prognosis is poor. We here report characteristics and clinical outcomes of patients with SGT discussed at the Charité molecular tumor board (MTB). Methods: Patients with advanced cancer and no curative treatment option were discussed at the Charité MTB. Eligible patients underwent fresh tissue sampling and subsequent whole exome (WES) and RNA sequencing (RNA-seq) and immunohistochemical analyses (EGFR, HER2, AR as well as validation tests) or panel sequencing. Results from molecular testing were discussed at the MTB and patients were followed-up after recommendations were made. Results: 24 patients (median age 56 years, 13 male, 11 female) with advanced SGT were presented at the MTB between 2016 and 2019 (9 adenoidcystic carcinomas, 5 adenocarcinomas, 3 mucoepidermoid, 2 carcinosarcoma, 5 miscellaneous). WES/RNA sequencing was performed on tumor tissue from 16 patients. 2 patients were not included in the sequencing program and WES/RNA-Seq was ongoing for another 4 patients at the time of analysis. For another 2 patients, panel sequencing and IHC analysis, respectively was done. Results from analyses were discussed and a median of 2 recommendations, ranked by priority according to prespecified evidence levels, were made for 17 patients, each. Most commonly proposed treatment options by the MTB were FGFR inhibitors in 6 patients, mTOR or PARP inhibitors in 5 each, EGFR, HDAC inhibitors or antiandrogen therapy in 4, each. Treatments following MTB recommendations were initiated in 8 patients, 1 of which received a second recommended therapy after progression (antiandrogen therapy in 4, EGFR inhibitor in 2, a PDGFR, mTOR and PARP inhibitor in 1, each). A clinical benefit (CR = 1; Mixed Response = 1, SD = 3) was achieved in 5 patients, including a complete response in a patient with a metastatic adenocarcinoma of the parotid gland, treated with antiandrogen therapy. Conclusions: Precision oncology represents a feasible treatment strategy in patients with advanced SGT and shows early evidence of activity in a subset of patients. These results suggest further exploration of personalized therapy in these hard-to-treat tumors.

Characteristics of 5015 Salivary Gland Neoplasms Registered in the Hiroshima Tumor Tissue Registry over a Period of 39 Years.

Salivary gland neoplasms are uncommon, and their epidemiology in Japan has not been well described. We conducted a retrospective review of salivary gland tumors registered in the Hiroshima Tumor Tissue Registry over a period of 39 years. The subjects were 5015 cases ranging in age from 6 to 97 (mean, 54.3) years old. The incidence of both benign tumors and malignant tumors increased with age until 60–69 years and then declined. Among the 5015 salivary gland neoplasms, 3998 (80%) were benign and 1017 (20%) were malignant. Pleomorphic adenoma (PA) was the most frequent benign tumor (68%), followed by Warthin tumor (26%). Adenoid cystic carcinoma (ACC) (27%) and mucoepidermoid carcinoma (MEC) (26%) were the two most frequent malignant tumors. Characteristically, there was a very low incidence of polymorphous adenocarcinoma in Japan. The average annual age-adjusted incidence rate per 100,000 population was 3.3 for benign tumors and 0.8 for malignant tumors. This is the large-scale multi-institutional analysis to describe the characteristics of salivary gland neoplasms, based on the pathological tissue registry data. We hope that the present data can contribute to early diagnosis and effective treatment of salivary gland tumors and to cancer prevention.

Downregulation of hypoxia‑inducible factor-1α inhibits growth, invasion, and angiogenesis of human salivary adenoid cystic carcinoma cells under hypoxia.

Surgical and medical treatments usually fail to completely remove the primary lesions of salivary adenoid cystic carcinoma (SACC), resulting in local recurrence due to its strong infiltration, hematogenous metastasis and other unique biological behaviors. Targeted gene therapy, including hypoxia‑inducible factor‑1α (HIF‑1α) therapy, sheds new light on the treatment of salivary gland tumors. However, the mechanisms underlying the downregulation of HIF‑1α expression in SACC have not been well studied. The present study aimed to determine the effects of HIF‑1α downregulation on the proliferation, invasion, apoptosis, cell cycle and angiogenesis of hypoxic SACC‑83 cells, and to elucidate the molecular mechanisms underlying these effects. Western blot analysis was used to evaluate the protein expression levels of HIF‑1α and matrix metalloproteinase‑2 (MMP‑2). Angiogenesis and the protein expression of vascular endothelial growth factor (VEGF) were detected by tube formation assay of human umbilical vein endothelial cells and ELISA, respectively. It was revealed that short hairpin RNA was considerably downregulated following overexpression of HIF‑1α. In addition, downregulation of HIF‑1α inhibited the expression of VEGF and MMP‑2, as well as the proliferation, invasion, migration, and tube formation of hypoxic SACC‑83 cells, while inducing apoptosis in these cells. These results suggest that the downregulation of HIF‑1α may be a novel targeted therapy for SACC.

Contemporary treatment of salivary gland tumors. A review of the literature

Contemporary treatment of salivary gland tumors. A review of the literature

Silymarin and its active component silibinin act as novel therapeutic alternatives for salivary gland cancer by targeting the ERK1/2-Bim signaling cascade.

Approximately 20% of all salivary gland cancer patients who are treated with current treatment modalities will ultimately develop metastases. Its most common form, mucoepidermoid carcinoma (MEC) is a highly aggressive tumor with an overall 5-year survival rate of ~30%. Until now, several chemotherapeutic drugs have been tested for the treatment of salivary gland tumors, but the results have been disappointing and the drugs often cause unwanted side effects. Therefore, several recent studies have focused on the potential of alternative and/or complementary therapeutic options, including the use of silymarin. The effects of silymarin and its active component silibinin on salivary gland cancer-derived MC3 and HN22 cells and their underlying molecular mechanisms were examined using trypan blue exclusion, 4'-6-diamidino-2-phenylindole (DAPI) staining, Live/Dead, Annexin V/PI staining, mitochondrial membrane potential (ΔΨm) measurement, quantitative RT-PCR, soft agar colony formation and Western blotting analyses. We found that silymarin and silibinin dramatically increased the expression of the pro-apoptotic protein Bim in a concentration- and time-dependent manner and, concomitantly, induced apoptosis in MC3 and HN22 cells. We also found that ERK1/2 signaling inhibition successfully sensitized these cells to the apoptotic effects of silymarin and silibinin, which indicates that the ERK1/2 signaling pathway may act as an upstream regulator that modulates the silymarin/silibinin-induced Bim signaling pathway. Taken together, we conclude that ERK1/2 signaling pathway inhibition by silymarin and silibinin increases the expression of the pro-apoptotic Bcl-2 family member Bim which, subsequently, induces mitochondria-mediated apoptosis in salivary gland cancer-derived cells.

Parotidectomy with simultaneously reconstruction after surgical defect

Objective : to improve the results of parotidectomy with using the simultaneously reconstruction surgery in the postoperative defects. Background . The radical surgical treatment for salivary gland tumors is parotidectomy with preservation of the facial nerve. However, this treatment leads to postoperative defects and Frey’s syndrome (25 % of cases). Elimination of the above-mentioned disadvantages requires plastic, reconstructive surgery. Materials and methods . In the department of head and neck tumors in the National Cancer Center of Uzbekistan during the period 2015 to 2016 were performed parotidectomy with preservation of the facial nerve and simultaneous retromandibular zone reconstruction with displacing muscle flap in 29 patients. In 25 (86 %) patients diagnosed mixed tumor (pleomorphic adenoma) and 4 (14 %) patients had cancer of parotid gland with the verification of histology. Results. In all of 29 patients were performed parotidectomy with preservation of the facial nerve and the simultaneous reconstruction of retromandibular zone with displacing own bodymuscle flap reduced postoperative complications, which had been revealed before as a defect and hypersensitivity of the retromandibular area. Conclusions . Reconstructive-restorative surgery in patients with tumors in the parotid gland after parotidectomy with saving of the facial nerve is decreased number of cosmetic defect and hypersensitivity. Using the own bodymuscle flap is preferred to patients than allotransplant.

Diffusion MRI: literature review in salivary gland tumors.

Surgical resection is currently the best treatment for salivary gland tumors. A reliable magnetic resonance imaging mapping, encompassing tumor grade, location, and extension may assist safe and effective tumor resection and provide better information for patients regarding potential risks and morbidity after surgical intervention. However, direct examination of the tumor grade and extension using conventional morphological MRI remains difficult, often requiring contrast media injection and complex algorithms on perfusion imaging to estimate the degree of malignancy. In addition, contrast-enhanced MRI technique may be problematic due to the recently demonstrated gadolinium accumulation in the dentate nucleus of the cerebellum. Significant developments in magnetic resonance diffusion imaging, involving voxel-based quantitative analysis through the measurement of the apparent diffusion coefficient, have enhanced our knowledge on the different histopathological salivary tumor grades. Other diffusion imaging-derived techniques, including high-order tractography models, have recently demonstrated their usefulness in assessing the facial nerve location in parotid tumor context. All of these imaging techniques do not require contrast media injection. Our review starts by outlining the physical basis of diffusion imaging, before discussing findings from diagnostic studies testing its usefulness in assessing salivary glands tumors with diffusion MRI.

Clinical analysis of salivary gland tumors and their treatment methods: An experience in treatment of 154 cases

Objectives: The aim of this study was to evaluate the treatment plan methods used in the treatment of different type &amp; site of salivary gland tumors.&#x0D; Materials and Methods: This study represents the experience of author in surgical treatment of 154 patients who were admitted in the clinic of maxillofacial surgery in the Babylon teaching hospital during the period May 2004- October 2010 for surgical treatment of salivary gland tumors. The clinical finding; distribution of patients according to the histology &amp; the site of origin is summarised. Analysis of different types of surgical procedures that used with others possible treatment &amp; recurrent rate were done.&#x0D; Result: There were 82 females (53.2%) &amp; 72 (46.8%) males. The average age of patients was 48.5 years. Parotid gland tumors represent 55.2% (85 patients), submandibular gland 20.7% (32 patients) &amp; minor salivary glands 24% (37 patients). Malignant tumors represent 42.2%, mostly in submandibular &amp; minor salivary glands while 57.7% were benign mostly in the parotid gland.&#x0D; Conclusions: Early diagnosis correlated with careful treatment plan selection depends on histopathology, staging and type of tumor leads to good prognosis of salivary gland tumors. When possible a conservative resection of the malignant tumor is recommended.

Intratumoral delivery of recombinant vaccinia virus encoding for ErbB2/Neu inhibits the growth of salivary gland carcinoma cells.

BackgroundThe antitumor activity induced by intratumoral vaccination with poxvirus expressing a tumor antigen was shown to be superior to that induced by subcutaneous vaccination. Salivary gland carcinomas overexpress ErbB2. Trastuzumab, a monoclonal antibody to ErbB2, was proposed for salivary gland tumors treatment. We explored the effectiveness of intratumoral vaccination with the recombinant vaccinia virus ErbB2/Neu (rV-neuT) vaccine in hampering the growth of transplanted Neu-overexpressing BALB-neuT salivary gland cancer cells (SALTO) in BALB-neuT mice.MethodsBALB-neuT male mice were subcutaneously injected with SALTO tumor cells and intratumorally vaccinated twice with different doses of either rV-neuT or V-wt (wild-type). Tumors were measured weekly. The presence of anti-ErbB2/Neu antibodies was assayed by ELISA, immunoprecipitation or indirect immunofluorescence. Biological activity of immune sera was investigated by analyzing antibody-dependent cellular cytotoxicity (ADCC), SALTO cells proliferation and apoptosis, ErbB2/Neu receptor down regulation and ERK1/2 phosphorylation. Anti-Neu T cell immunity was investigated by determining the release of IL-2 and IFN-gamma in T cells supernatant. Survival curves were determined using the Kaplan-Meier method and compared using the log-rank test. Differences in tumor volumes, number of apoptotic cells, titer of the serum, percentage of ADCC were evaluated through a two-tailed Student’s t-test.ResultsrV-neuT intratumoral vaccination was able to inhibit the growth of SALTO cancer cells in a dose-dependent manner. The anti-Neu serum titer paralleled in vivo antitumor activity of rV-neuT vaccinated mice. rV-neuT immune serum was able to mediate ADCC, inhibition of SALTO cells proliferation, down regulation of the ErbB2/Neu receptor, inhibition of ERK1/2 phosphorylation and induction of apoptosis, thus suggesting potential mechanisms of in vivo tumor growth interference. In addition, spleen T cells of rV-neuT vaccinated mice released IFN-gamma and IL-2 upon in vitro stimulation with several Neu-specific peptides located in the extracellular domain of Neu sequence.ConclusionsrV-neuT intratumoral vaccination could be employed to induce an efficient antitumor response and reject transplanted salivary gland tumors. Our findings may have important implications for the design of cancer vaccine protocols for the treatment of salivary gland tumors and other accessible tumors using intratumoral injection of recombinant vaccinia virus.

Management of salivary gland tumors

Surgery after proper imaging (MRI or CT scan) is the main stay of treatment for salivary gland tumors. Although excision margins should be ≥5 mm for malignant tumors in cases of parotid gland carcinoma, the facial nerve should be preserved whenever it is not infiltrated. Adjuvant external radiation is indicated for malignant tumors with high-risk features such as close (or invaded) margins, perineural speed, lymphatic and/or vascular invasion, lymph-node involvement and high-grade histology. A Phase II trial testing adjuvant concomitant cisplatin plus radiation therapy versus adjuvant radiation therapy alone after surgery is currently under investigation for high-risk salivary gland cancer. For inoperable cancers, photons combined with proton boost seem to be a valuable option. Even if protons or carbon ions are promising, access to the latter is limited for usual treatment. For recurrent and/or metastatic cancer, polychemotherapy (cisplatin based) gives a 25% response rate in adenoid cystic carcinoma and should be used when the disease is overtly in progression. Targeted therapies with anti-EGF receptor molecules, antiangiogenic agents and tyrosine kinase inhibitors are ongoing, but more trials are needed to establish their efficacy, as is the use of bortezomib followed by doxorubicin. The products of fusion oncogenes, which have a pathogenic role in some adenoid cystic carcinoma and mucoepidermoid carcinomas, are of interest as potential therapeutic targets.

Guidelines On the diagnosis and treatment of salivary gland tumors

涎腺肿瘤是常见的口腔颌面部肿瘤,病理类型十分复杂,以往对各种类型肿瘤的临床病理特点和生物学行为缺乏深入了解,治疗方面争议较多.近二十年国内专家对涎腺肿瘤的诊断和治疗进行了较系统的研究,明确了各型肿瘤的临床病理特点和生物学行为,对涎腺肿瘤的诊治原则达成许多共识。

Developing the guidelines to improve the level of diagnosis and treatment of salivary gland tumors

涎腺肿瘤是常见的口腔颌面部肿瘤之一.根据国内7家口腔医学院口腔病理科的统计资料,在66 902例口腔颌面部肿瘤中,涎腺上皮性肿瘤达23 010例,占32.9%,其中75%～80%为腮腺肿瘤。