Parotid Gland Cancer: Adjuvant Treatment After Revision Surgery for Resectable Recurrent Locoregional Disease
Clinical Scenario
This protocol applies to patients with resectable recurrent locoregional salivary gland cancer and no distant metastatic disease, at the point when adjuvant therapy decisions are required following revision surgical resection.
Previous Treatment Step & Escalation Trigger
The preceding step was revision surgical resection — with comprehensive or elective neck dissection as appropriate — targeting negative surgical margins. This protocol defines the adjuvant treatment strategy that follows revision surgery, particularly when that margin goal was not achieved or when post-surgical adjuvant planning is required.
Treatment Direction (partial overview)
Patients are evaluated for adjuvant therapy after revision surgery. The approach centres on a form of radiation therapy, with the specific modality and eligibility depending on whether radiation formed part of prior primary treatment.
Full selection criteria, options, and sequencing are available in the complete protocol →
References
DOI: 10.1200/JCO.21.00449
- In the setting of resectable, recurrent locoregional disease and no distant metastatic disease, regardless of prior treatment type, patients should be offered revision resection and appropriate surgical reconstruction and rehabilitation.
- Patients undergoing revision surgery for recurrent salivary gland cancer should be evaluated for potential adjuvant therapy.
- If no previous adjuvant treatment was given as part of primary treatment, adjuvant RT should be planned after revision surgery.
- If previous radiation was completed, selected patients may be eligible for consideration of adjuvant re-irradiation or intraoperative interventions such as intraoperative RT or brachytherapy at selected centers.
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