Malignant salivary gland tumors: role of radiation therapy

Malignant salivary gland tumors are rare. They represent less than one percent of all head and neck tumors. Approximately three fourths of all salivary gland tumors occur in the major salivary glands.Traditionally, the treatment of choice for these tumors is surgery. The majority of these tumors reoccur after curative surgical procedures. Local recurrence rate following surgery varies with the histology, grade, and extent of the disease.In spite of high local recurrence rate following curative surgical treatment of these tumors, radiotherapy has seldom been used as an adjuvant to surgery. The value of elective postoperative radiation therapy for subclinical microscopic disease was not recognized. Review of the literature supports the improved local control rate with the use of immediate postoperative radiotherapy. Radiation therapy proved to be effective as an adjuvant to surgery. A local control rate of better than 40 percent can be achieved by radiation therapy as a sole modality in inoperable and locally advanced cases. Radiation therapy provides an excellent palliation for locally advanced tumors or symptomatic metastases.