Postoperative external beam radiation therapy for salivary gland cancer in adults and adolescents. Clinical cases

Tumors of the salivary glands account for 1-5% of all cancers and 3% of tumors in the head and neck area. They most commonly occur in people between the ages of 15 and 39, with approximately 5% of cases happening before the age of 20. The majority of tumors affect the parotid glands (up to 72% of cases), with mucoepidermoid carcinoma being the most common type of malignant tumor in this region. Treatment for primary malignant tumors in salivary glands typically begins with surgery followed by radiation therapy based on the results of a histological examination. In recent years, there has been a focus on factors that can affect the prognosis for head and neck tumors. With the development of advanced radiation therapy techniques, it has become possible to minimize severe side effects and damage. In this study, we compare the effectiveness of IMRT (Intensity-Modulated Radiation Therapy) and 3D conformal chemoradiotherapy. No significant differences were found in the incidence of acute radiation reactions (p = 0.83). Based on our clinical observations of patients who underwent postoperative radiation therapy for mucous epidermoid cancer of the parotid salivary gland, we have shown that radiation therapy is a necessary component of modern treatment for this disease, especially in the presence of unfavourable prognostic factors such as close edges of resection and T3-T4 stages according to the TNM classification, as well as perineural invasion. At the same time, the use of modern radiotherapy techniques such as VMAT (volumetric modulated arc therapy), in compliance with dosimetric requirements for critical structures, does not lead to a deterioration of the quality of life for patients and is associated with minimal adverse reactions in the context of multimodal treatment (surgery, radiotherapy, chemotherapy).