Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes
Abstract Introduction Adjuvant radiotherapy is an established component in the management of metastatic cutaneous squamous cell carcinoma (SCC) involving the parotid gland. Radiotherapy technique, dose and volumes are seldom described sufficiently to allow close examination. We report our treatment...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-06-01
|
| Series: | Journal of Medical Radiation Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jmrs.650 |
| _version_ | 1827928098951135232 |
|---|---|
| author | Marcus Hu Anna N. H. Kim Theophilus I. Emeto Michael Collins Andrea Chopping Charles Lin |
| author_facet | Marcus Hu Anna N. H. Kim Theophilus I. Emeto Michael Collins Andrea Chopping Charles Lin |
| author_sort | Marcus Hu |
| collection | DOAJ |
| description | Abstract Introduction Adjuvant radiotherapy is an established component in the management of metastatic cutaneous squamous cell carcinoma (SCC) involving the parotid gland. Radiotherapy technique, dose and volumes are seldom described sufficiently to allow close examination. We report our treatment outcomes and focus on treatment‐related factors that affect outcomes in this cohort. Methods We performed a retrospective review of patients with metastatic cutaneous SCCs who underwent parotidectomy with or without ipsilateral neck dissection. All patients received adjuvant radiotherapy. Demographics, clinical data and treatment details were collected from an intuitional electronic database. Individual patient‐level radiotherapy technique, volumes and doses were reviewed. Results Between July 2008 and July 2018, 60 patients met our inclusion criteria. Median follow‐up duration was 32.7 months. The mean age was 66.4 years. The majority of patients (49 patients) received full neck irradiation. The 2‐year and 5‐year loco‐regional failure‐free survival was 87% (95% confidence interval (CI): 0.74–0.93) and 71% (95% CI: 0.52, 0.83), respectively. The 2‐year and 5‐year overall survival was 76% (95% CI: 0.62, 0.85) and 60% (95% CI: 0.45, 0.72), respectively. There were 15 cases of loco‐regional failures, with 6 cases with dermal involvement. Lymphovascular invasion (LVI) was associated with higher loco‐regional failure (hazard ratio: 8.43, 95% CI: 1.85–38.39, P = 0.005) and cancer‐specific mortality (hazard ratio: 5.40, 95% CI: 1.40–20.87, P = 0.015). Treatment technique, intensity‐modulated radiation therapy (IMRT) vs 3D conformal radiotherapy (3D CRT), bolus use, perineural invasion (PNI) and surgical margins were not significantly associated with loco‐regional failure. Conclusion We demonstrated high loco‐regional control rates with routine use of comprehensive adjuvant radiotherapy. The presence of LVI was identified as a strong predictor for recurrence. Further analysis will help to define optimal radiation dose and techniques. |
| first_indexed | 2024-03-13T06:02:39Z |
| format | Article |
| id | doaj.art-e29df295e26a4dfcb9a531e180820e95 |
| institution | Directory Open Access Journal |
| issn | 2051-3895 2051-3909 |
| language | English |
| last_indexed | 2024-03-13T06:02:39Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Medical Radiation Sciences |
| spelling | doaj.art-e29df295e26a4dfcb9a531e180820e952023-06-12T08:46:58ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092023-06-0170216117010.1002/jmrs.650Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomesMarcus Hu0Anna N. H. Kim1Theophilus I. Emeto2Michael Collins3Andrea Chopping4Charles Lin5Townsville Cancer Centre Townsville Hospital and Health Service Townsville Queensland AustraliaFaculty of Medicine University of Queensland Brisbane Queensland AustraliaPublic Health & Tropical Medicine, College of Public Health, Medical & Veterinary Sciences James Cook University Townsville Queensland AustraliaTownsville Cancer Centre Townsville Hospital and Health Service Townsville Queensland AustraliaTownsville Cancer Centre Townsville Hospital and Health Service Townsville Queensland AustraliaFaculty of Medicine University of Queensland Brisbane Queensland AustraliaAbstract Introduction Adjuvant radiotherapy is an established component in the management of metastatic cutaneous squamous cell carcinoma (SCC) involving the parotid gland. Radiotherapy technique, dose and volumes are seldom described sufficiently to allow close examination. We report our treatment outcomes and focus on treatment‐related factors that affect outcomes in this cohort. Methods We performed a retrospective review of patients with metastatic cutaneous SCCs who underwent parotidectomy with or without ipsilateral neck dissection. All patients received adjuvant radiotherapy. Demographics, clinical data and treatment details were collected from an intuitional electronic database. Individual patient‐level radiotherapy technique, volumes and doses were reviewed. Results Between July 2008 and July 2018, 60 patients met our inclusion criteria. Median follow‐up duration was 32.7 months. The mean age was 66.4 years. The majority of patients (49 patients) received full neck irradiation. The 2‐year and 5‐year loco‐regional failure‐free survival was 87% (95% confidence interval (CI): 0.74–0.93) and 71% (95% CI: 0.52, 0.83), respectively. The 2‐year and 5‐year overall survival was 76% (95% CI: 0.62, 0.85) and 60% (95% CI: 0.45, 0.72), respectively. There were 15 cases of loco‐regional failures, with 6 cases with dermal involvement. Lymphovascular invasion (LVI) was associated with higher loco‐regional failure (hazard ratio: 8.43, 95% CI: 1.85–38.39, P = 0.005) and cancer‐specific mortality (hazard ratio: 5.40, 95% CI: 1.40–20.87, P = 0.015). Treatment technique, intensity‐modulated radiation therapy (IMRT) vs 3D conformal radiotherapy (3D CRT), bolus use, perineural invasion (PNI) and surgical margins were not significantly associated with loco‐regional failure. Conclusion We demonstrated high loco‐regional control rates with routine use of comprehensive adjuvant radiotherapy. The presence of LVI was identified as a strong predictor for recurrence. Further analysis will help to define optimal radiation dose and techniques.https://doi.org/10.1002/jmrs.650adjuvant skin neoplasms retrospective studies carcinomaradiotherapysquamous cell parotid neoplasms |
| spellingShingle | Marcus Hu Anna N. H. Kim Theophilus I. Emeto Michael Collins Andrea Chopping Charles Lin Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes Journal of Medical Radiation Sciences adjuvant skin neoplasms retrospective studies carcinoma radiotherapy squamous cell parotid neoplasms |
| title | Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes |
| title_full | Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes |
| title_fullStr | Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes |
| title_full_unstemmed | Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes |
| title_short | Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes |
| title_sort | metastatic cutaneous squamous cell carcinoma to the parotid adjuvant radiotherapy and treatment outcomes |
| topic | adjuvant skin neoplasms retrospective studies carcinoma radiotherapy squamous cell parotid neoplasms |
| url | https://doi.org/10.1002/jmrs.650 |
| work_keys_str_mv | AT marcushu metastaticcutaneoussquamouscellcarcinomatotheparotidadjuvantradiotherapyandtreatmentoutcomes AT annanhkim metastaticcutaneoussquamouscellcarcinomatotheparotidadjuvantradiotherapyandtreatmentoutcomes AT theophilusiemeto metastaticcutaneoussquamouscellcarcinomatotheparotidadjuvantradiotherapyandtreatmentoutcomes AT michaelcollins metastaticcutaneoussquamouscellcarcinomatotheparotidadjuvantradiotherapyandtreatmentoutcomes AT andreachopping metastaticcutaneoussquamouscellcarcinomatotheparotidadjuvantradiotherapyandtreatmentoutcomes AT charleslin metastaticcutaneoussquamouscellcarcinomatotheparotidadjuvantradiotherapyandtreatmentoutcomes |