Radiotherapy for salivary gland cancer: REFCOR recommendations by the formal consensus method

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Cancer

Background:

• Salivary gland cancers are rare but can have aggressive behavior.
• Identifying appropriate indications for radiotherapy is crucial for improving patient outcomes.
• Current guidelines for radiotherapy in these cancers require clear definition.

Purpose of the Study:

• To define the indications for radiotherapy in salivary gland cancer.
• To specify the recommended radiation modalities and target volumes.
• To establish evidence-based recommendations for clinical practice.

Main Methods:

• A narrative review of Medline-published literature was conducted.
• Recommendations were drafted by a steering group from the French Network of Rare Head and Neck Tumors (REFCOR).
• Adherence to recommendations was assessed using a formal consensus method.

Main Results:

• Postoperative radiotherapy is indicated for salivary gland cancer with adverse histoprognostic factors (e.g., T3-T4, lymph node invasion, close margins).
• Intensity-modulated radiation therapy (IMRT) is the gold standard modality.
• Carbon ion hadrontherapy may be considered for unresectable or inoperable cases.

Conclusions:

• Radiotherapy is indicated in postoperative salivary gland cancer when adverse histoprognostic factors are present.
• Radiotherapy is also indicated for inoperable salivary gland tumors.
• These recommendations aim to optimize treatment strategies for salivary gland cancer.