The following is a summary of “Chemoradiotherapy versus radiotherapy in high risk salivary gland cancer,” published in the July 2024 issue of Surgery by Shen et al.
This study aimed to comprehensively assess the potential survival benefits associated with chemoradiotherapy (CRT) versus radiotherapy (RT) in patients with surgically treated high-risk salivary gland cancer (SGC), focusing particularly on the influence of various high-risk factors on treatment outcomes.
The retrospective analysis included patients who had undergone surgical treatment for high-risk SGC and were categorized into either CRT or RT groups. Propensity score-matching ensured a balanced comparison between treatment modalities. The impact of adjuvant therapy on both locoregional control (LRC) and overall survival (OS) was rigorously evaluated using a multivariable Cox proportional hazards model. This approach allowed for a nuanced exploration of how CRT versus RT affected outcomes across different subsets of patients characterized by varying combinations of high-risk factors.
After matching 152 patients, the study found that, overall, CRT did not demonstrate statistically significant improvements in LRC (p = 0.485, HR: 1.14, 95% CI: 0.36–4.22) or OS (p = 0.367, HR: 0.99, 95% CI: 0.17–3.87) compared to RT. However, among patients with specific high-risk features—such as T3/4 stage tumors, high-grade histology, and 5 or more positive lymph nodes—the addition of chemotherapy to radiotherapy showed a notable 15% reduction in the risk of cancer recurrence (p = 0.042, 95% CI: 4–54%). This finding underscores the potential benefit of CRT in mitigating disease recurrence in a subset of patients with high-risk SGC.
The study highlights the importance of personalized treatment strategies in high-risk SGC, where the incorporation of adjuvant chemotherapy alongside radiotherapy could be particularly advantageous for patients with more aggressive tumor characteristics. These findings contribute to the ongoing discourse on optimizing therapeutic approaches in oncology, emphasizing the need for tailored treatments based on individualized risk profiles to improve outcomes and enhance patient care in the management of high-risk salivary gland cancer.
Source: wjso.biomedcentral.com/articles/10.1186/s12957-024-03456-9
