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Management algorithm for HIV-associated parotid lymphoepithelial cysts.

Waleed F Mourad1,2, Shyamal Patel3,4, Rebekah Young4

  • 1Department of Radiation Oncology, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 4G, New York, NY, 10003, USA. Waleed246@gmail.com.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|February 17, 2016
PubMed
Summary
This summary is machine-generated.

Radiation therapy for benign lymphoepithelial cysts (BLEC) in HIV patients is effective. A dose of 24 Gy provides long-term cosmetic control with minimal toxicity, establishing an evidence-based management algorithm.

Keywords:
AIDSBenign lymphoepithelial cystsHAARTHIVParotid glandRadiation therapy

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Area of Science:

  • Oncology
  • Radiology
  • HIV Medicine

Background:

  • Benign lymphoepithelial cysts (BLEC) of the parotid glands are common in HIV-positive patients.
  • Management of BLEC in this population can be challenging.
  • Radiation therapy is a potential treatment modality.

Purpose of the Study:

  • To establish an evidence-based management algorithm for parotid gland BLEC in HIV patients.
  • To determine the optimal radiation dose for long-term cosmetic control.
  • To evaluate treatment outcomes and toxicities associated with radiation therapy.

Main Methods:

  • Retrospective analysis of 72 HIV-positive patients with parotid BLEC treated between 1987 and 2013.
  • Patients were divided into two groups based on radiation dose: ≤18 Gy (Group A) and ≥22.5 Gy (Group B).
  • Outcomes assessed included overall response, complete response, partial response, local failure, and toxicity (RTOG grade).

Main Results:

  • Group A (median 10 Gy) showed 7% overall response and 93% local failure.
  • Group B (median 24 Gy) demonstrated 88% overall response, 65% complete response, and 12% local failure.
  • Higher radiation dose (≥22.5 Gy) significantly predicted for cosmetic control (p < 0.001), with no RTOG grade ≥3 toxicities observed.

Conclusions:

  • A radiation dose of 24 Gy, delivered in 12-16 fractions, provides effective long-term cosmetic control for parotid gland BLEC in HIV patients.
  • This dose establishes an evidence-based management algorithm.
  • Radiation therapy is a safe and effective treatment option with minimal toxicity.