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Clinical target volume design of postoperative intensity-modulated radiotherapy for major salivary gland tumours according to surgical principles: an innovative method

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Background

No international consensus has been reached regarding delineation of postoperative intensity-modulated radiotherapy (PO-IMRT) clinical target volumes (CTV) for major salivary gland carcinoma (SGC). The purpose of this article was to report our experience according to surgical principles.

Methods

Between June 2010 and June 2018, 54 consecutive patients were enrolled. Reserved tissues around the margin of resection that were less than 5 mm from the invasive tumour edge before surgery were defined as high-risk clinical target volumes (CTV-HD), those less than 10 mm away were defined as medium-risk CTV (CTV1), and those 10–20 mm away were defined as low-risk CTV (CTV2), and were irradiated with 63–65 Gy, 59.5–61 Gy, and 45–54 Gy, respectively. Target volume distributions of reserved tissues were analysed and actuarial estimates of overall survival (OS), recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) were obtained with the Kaplan–Meier method.

Results

In parotid gland tumours, the percentages of defined CTV-HD in the styloid process, mandibular ramus, posterior venter of the digastric muscle, carotid sheath and stylomastoid foramen reached 34.29%, 25.71%, 54.29%, 40.00%, and 37.10%, respectively. The median follow-up was 33 months (range, 5–98 months). The 3-year and 5-year Kaplan–Meier estimates of OS, RFS and DMFS were 85.4% and 77.8%, 97.4%, and 97.4%, and 82.0% and 82.0%, respectively.

Conclusions

It is feasible to delineate CTVs according to distances between various reserved tissues and the primary tumour edge before operation.

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Authors and Affiliations

  1. Department of Radiation Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

    Shaowen Lyu, Zhiqing Long, Jiang Hu & Yong Su

  2. Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of **angya School of Medicine, Central South University, Changsha, China

    Zheng Wu

  3. Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

    Dehuan **e

  4. Department of Radiation Oncology, Hainan General Hospital, Hainan Clinical Medicine Research Institution, Haikou, China

    Rui Zhong

  5. VIP Department, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

    Wang Lei

  6. Department of Radiation Oncology, Shunde Hospital, Southern Medical University, Foshan, China

    Wanqin Cheng

  7. Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

    Xuekui Liu

  8. Department of Medical Imaging and Interventional Radiology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dong Feng Road East, Guangzhou, 510060, People’s Republic of China

    Chuanmiao **e

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  1. Shaowen Lyu
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Lyu, S., Wu, Z., **e, D. et al. Clinical target volume design of postoperative intensity-modulated radiotherapy for major salivary gland tumours according to surgical principles: an innovative method. J Cancer Res Clin Oncol 148, 921–930 (2022). https://doi.org/10.1007/s00432-021-03646-y

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