Chemotherapy for salivary gland cancer

Salivary gland cancers are usually treated with surgery and irradiation; however, some of the aggressive salivary gland cancers recur or metastasize and are not amendable to treatment with further surgery or irradiation. Little is known about chemotherapy for these palliative situations because of the relatively scarcity of these cancers. The data in the literature has provided little clinical information because all salivary gland cancers are usually lumped together and/or multiple different drug combination are used. In an effort to arrive at a rational basis for recommending specific drug regimens for specific histologic types of salivary gland cancers, a two-part study was undertaken to determine which chemotherapy drugs seem to be effective or ineffective. One part was a literature review, and the second part was a survey of numerous institutions' experiences, including our own. A total of 85 cases of salivary gland cancers treated with chemotherapy were felt to be evaluable for this study. The overall response rate (complete and partial) was 42%. Although disease responded whether it was local, regional, or distant disease, there was a higher response rate in local-regional disease compared to distant metastases. Salivary gland cancers are definitely sensitive to chemotherapy drugs. This study reveals which drugs seem to be effective and provides some rational basis for future chemotherapy trials for salivary gland cancers.