Supporting the use of adjuvant radiotherapy in recurrent pleomorphic adenoma of the parotid

Abstract

Background

The use of adjuvant radiotherapy remains controversial in the treatment of recurrent pleomorphic adenomas.

Aims/objectives

The aim of this study was to provide the highest level of evidence possible by performing a systematic review and meta-analysis of the literature.

Material and methods

We searched the English-language literature between 1985 and 2019.Inclusion criteria included any study on the treatment and outcome of recurrent pleomorphic adenomas. Exclusion criteria included the use of radiotherapy for residual tumors, case reports, and pleomorphic adenomas not arising from the parotid.

Results

A total of 522 abstracts were studied, data analyzed from 14 studies, on a total of 697 patients. When the data werepooled, the overall risk of further recurrence was 21%. In studies where surgery alone was undertaken this increased to 26% and decreased to 10% in those receiving adjuvant radiotherapy (p = .000). There were 21 recurrences in 159 patients in the radiotherapy group, and 151 recurrences out of 538 patients in the surgery group (p < .0001).

Conclusions

These data support the use of radiotherapy to decrease the risk of re-recurrence in recurrent pleomorphic adenoma.

Significance

This study is the highest level of evidence currently available in guiding management of recurrent pleomorphic adenoma.

Chinese abstract

背景：在复发性多形性腺瘤的治疗中, 辅助放疗的运用仍存在争议。

目的：本研究的目的是通过对相关文献进行系统回顾和荟萃分析, 提供尽可能高质量的证据。

材料和方法：我们检索了 1985 年至2019的英文文献, 纳入标准包括任何关于复发性多形性腺瘤治疗和结果的研究。排除标准包括对残留肿瘤使用放疗、病例报告和不是源自腮腺的多形性腺瘤。

结果：共研究了 522 篇摘要, 分析了对共697位患者进行的 14 项研究的数据。汇总数据后, 进一步复发的总体风险为 21%。在研究中, 仅进行手术的患者增加到 26%, 接受辅助放疗的患者减少到 10%（p ¼ .000）。放疗组159位患者中复发21例, 手术组 538 名患者中复发151例（p < .0001）。

结论：这些数据支持使用放疗降低复发性多形性腺瘤的复发风险。

意义：本研究是目前可用于指导复发性多形性腺瘤管理的最高质量的证据。

Keywords:

• Pleomorphic adenoma
• recurrent
• radiotherapy
• meta-analysis

Acknowledgement

The authors have no financial disclosures.

Disclosure statement

No potential conflict of interest was reported by the author(s).