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Review
. 2024 Jun 28;16(13):2375.
doi: 10.3390/cancers16132375.

The Current Position of Postoperative Radiotherapy for Salivary Gland Cancer: A Systematic Review and Meta-Analysis

Jingbo Wang  1 , Ji Eun Moon  2 , Xin Guo  1 , Jiaqi Yu  1 , Junlin Yi  1 , Sun Hyun Bae  3
Affiliations
Review

The Current Position of Postoperative Radiotherapy for Salivary Gland Cancer: A Systematic Review and Meta-Analysis

Jingbo Wang et al. Cancers (Basel). .

Abstract

Background: Because of the rarity, heterogeneous histology, and diverse anatomical sites of salivary gland cancer (SGC), there are a limited number of clinical studies on its management. This study reports the cumulative evidence of postoperative radiotherapy (PORT) for SGC of the head and neck.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases between 7th and 10th November 2023.

Results: A total of 2962 patients from 26 studies between 2007 and 2023 were included in this meta-analysis. The median RT dose was 64 Gy (range: 56-66 Gy). The median proportions of high-grade, pathological tumor stage 3 or 4 and pathological lymph node involvement were 42% (0-100%), 40% (0-77%), and 31% (0-75%). The pooled locoregional control rates at 3, 5, and 10 years were 92% (95% confidence interval [CI], 89-94%), 89% (95% CI, 86-93%), and 84% (95% CI, 73-92%), respectively. The pooled disease-free survival (DFS) rates at 3, 5, and 10 years were 77% (95% CI, 70-83%), 67% (95% CI, 60-74%), and 61% (95% CI, 55-67%), respectively. The pooled overall survival rates at 3, 5, and 10 years were 84% (95% CI, 79-88%), 75% (95% CI, 72-79%), and 68% (95% CI, 62-74%), respectively. Severe late toxicity ≥ grade 3 occurred in 7% (95% CI, 3-14%).

Conclusion: PORT showed favorable long-term efficacy and safety in SGC, especially for patients with high-grade histology. Considering that DFS continued to decrease, further clinical trials exploring treatment intensification are warranted.

Keywords: postoperative radiotherapy; radiotherapy; salivary gland cancer.

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Conflict of interest statement

There are no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) algorithm.
Figure 2
Figure 2
Forest plot of (A) 3-year locoregional control (LRC), (B) 5-year LRC, (C) 3-year disease-free survival (DFS), (D) 5-year DFS, (E) 3-year DFS between cohorts treated with postoperative concurrent chemoradiotherapy (Post-op_CCRT) versus cohorts with postoperative radiotherapy alone (PORT), and (F) 3-year DFS between cohorts with the proportion of a high grade ≥ 50% versus cohorts with the proportion of a high grade < 50%.
Figure 2
Figure 2
Forest plot of (A) 3-year locoregional control (LRC), (B) 5-year LRC, (C) 3-year disease-free survival (DFS), (D) 5-year DFS, (E) 3-year DFS between cohorts treated with postoperative concurrent chemoradiotherapy (Post-op_CCRT) versus cohorts with postoperative radiotherapy alone (PORT), and (F) 3-year DFS between cohorts with the proportion of a high grade ≥ 50% versus cohorts with the proportion of a high grade < 50%.
Figure 2
Figure 2
Forest plot of (A) 3-year locoregional control (LRC), (B) 5-year LRC, (C) 3-year disease-free survival (DFS), (D) 5-year DFS, (E) 3-year DFS between cohorts treated with postoperative concurrent chemoradiotherapy (Post-op_CCRT) versus cohorts with postoperative radiotherapy alone (PORT), and (F) 3-year DFS between cohorts with the proportion of a high grade ≥ 50% versus cohorts with the proportion of a high grade < 50%.
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