Materiały źródłowe

• #1 Parotid Gland Tumors: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/parotid-tumor

  A parotid gland tumor is a rare tumor on one of your salivary glands. Most parotid tumors are benign (noncancerous), but they can be cancerous. Both types cause a lump in front of one of your ears. Surgery treats both types and cures noncancerous parotid gland tumors. Providers may also use radiation therapy to treat cancerous tumors. […] Treatment typically involves surgery to remove the tumor. Surgery cures noncancerous tumors and may cure cancerous ones, as well. But cancerous parotid gland tumors can come back (recur). […] Parotidectomy, which is surgery to remove part or all of your parotid gland, is the most common treatment for cancerous and noncancerous tumors. People with cancerous tumors also receive radiation therapy after surgery.

• #2 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Superficial parotidectomy with identification and exposure of was traditionally the preferred procedure. The facial nerve us found 1cm inferior and 1-cm deep to the tragal pointer and bisecting the angle of the insertion of the digastric muscle into the digastric ridge. It is now generally accepted that an adequate margin in benign tumors, is a cuff of 1 to 2 mm. There is thus an increasing recognition that operations less than the traditional procedures are acceptable. Partial parotidectomy or hemi-superficial parotidectomy has become commonplace. An extracapsular dissection for benign pathology, away from the main branches of the facial nerve is an option, and even endoscopically-assisted parotidectomy can be effective in selected patients. These procedures should be undertaken by expert surgeons in carefully selected cases, e.g., small tumors confined to the superficial lobe. A „lumpectomy” is not considered an appropriate procedure due to high recurrence rates. Recurrence will occur if there has been incomplete excision and may occur if there has been tumor spillage. Complications from parotid surgery are well documented and include a scar, facial nerve injury, hematoma, seroma, salivary fistula, and Frey syndrome (gustatory sweating).

• #3 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Parotid tumor treatment often involves surgery to remove the tumor. If the tumor is cancerous, you might need more treatment. This could be with radiation therapy and chemotherapy. […] Operations used to remove parotid tumors include: Removing part of the parotid gland. For most parotid tumors, surgeons may cut away the tumor and some of the healthy parotid gland tissue around it. The part of the parotid gland that’s left continues working as before. […] Removing all of the parotid gland. Surgery to remove all of the parotid gland is called parotidectomy. It might be needed for larger tumors, tumors that are cancerous and those that affect the deeper parts of the parotid gland. […] Removing more tissue to get all of the cancer. If parotid gland cancer has grown into nearby bone and muscles, some of these may be taken out with the parotid gland. Surgeons try to remove all of the cancer and a small amount of the healthy tissue that surrounds it.

• #4 Salivary Gland Neoplasms Treatment & Management: Medical Therapy, Surgical Therapy, Intraoperative Details

  https://emedicine.medscape.com/article/852373-treatment

  Surgical Therapy […] Carefully planned and executed surgical excision is the primary treatment for all primary salivary gland tumors. […] Superficial parotidectomy with identification and dissection of the facial nerve is the minimum operation for diagnosis and treatment of parotid masses. […] Surgery is the primary treatment of malignant tumors of the salivary glands. This is often combined with postoperative radiation therapy, depending on the specific tumor characteristics and stage. […] The facial nerve should not be sacrificed for benign tumors. […] The histopathologic diagnosis of parotid masses is often unknown prior to surgery. […] The shift from enucleation, which was popular prior to 1950, to superficial parotidectomy as the minimal procedure for parotid tumors has substantially reduced recurrence rates for both benign and malignant disease. […] For benign pathology, this procedure is curative. […] By today’s standards, enucleation with incisional biopsies should never be performed.

• #5 Parotid tumors | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/parotid-tumors?content_id=CON-20380680

  Parotid tumor treatment often involves surgery to remove the tumor. If the tumor is cancerous, you might need more treatment. This could be with radiation therapy and chemotherapy. […] Operations used to remove parotid tumors include: Removing part of the parotid gland. For most parotid tumors, surgeons may cut away the tumor and some of the healthy parotid gland tissue around it. The part of the parotid gland that’s left continues working as before. […] Removing all of the parotid gland. Surgery to remove all of the parotid gland is called parotidectomy. It might be needed for larger tumors, tumors that are cancerous and those that affect the deeper parts of the parotid gland. […] Removing more tissue to get all of the cancer. If parotid gland cancer has grown into nearby bone and muscles, some of these may be taken out with the parotid gland. Surgeons try to remove all of the cancer and a small amount of the healthy tissue that surrounds it.

• #6 Parotidectomy (Parotid Gland Tumor Surgery) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/salivary-gland/salivary-gland-cancer-treatment/parotidectomy-parotid-gland-tumor-surgery

  MSKs parotid gland surgeons, including Ian Ganly, have extensive experience in using precise techniques that help preserve the facial nerve. […] For many people with parotid gland tumors, surgery performed by a head and neck surgeon is the main treatment. This operation is called a parotidectomy. […] Treating parotid gland tumors requires great precision on the part of your surgical team because the facial nerve is nearby. The facial nerve controls your ability to close your eyes, raise your eyebrows, and smile. […] Preserving the facial nerve is an important priority when removing a parotid gland tumor. The facial nerve is typically identified and protected during a parotidectomy. However, there is a chance that the nerve may be adversely affected by the tumor itself or by the surgical procedure needed to remove the tumor.

• #7 Parotid Tumors Treatment – Parotid Tumor Surgery | Salivary Gland Surgery Los Angeles CA

  https://parotid.net/parotid-tumors/

  First line treatment for all parotid tumors, both benign and malignant, is generally surgical removal of the gland. The main risk to the surgery which is called parotidectomy is facial nerve paralysis. […] The treating surgeon must be experienced and familiar enough to successfully identify, separate, and preserve this crucial structure and all its branches. In some cases of parotid tumor, the facial nerve can be involved or compressed within the tumor, adding further complexity to the case. A qualified salivary gland specialist has performed hundreds of these cases and is prepared for the meticulous nature of such a procedure. These physicians employ specialized protocols to identify this crucial nerve and its branches while minimizing any intraoperative trauma or subsequent risk of facial paralysis.

• #8 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  In small, low-grade superficial parotid tumors, a superficial parotidectomy with a margin of at least 1.5 cm may suffice, but otherwise, a total conservative parotidectomy is advised with resection of adjacent neck structures if necessary to achieve an en-bloc resection. A functioning facial nerve should be preserved unless found to be infiltrated with the tumor itself at the time of resection. If the nerve is sacrificed because of involvement, then primary nerve grafting should be performed. The greater auricular nerve as a donor is an option, but it may be involved, so the sural nerve from the leg may be preferred. […] Salivary gland neoplasms respond poorly to chemotherapy, with adjuvant chemotherapy used only for palliation. Adjuvant radiotherapy is recommended for large tumors (greater than 4 cm), patients with incomplete or close margins, recurrent disease, perineural and vascular invasion, nodal disease, in metastatic disease, and is usually indicated for adenoid cystic carcinomas and high-grade tumors.

• #9 Salivary gland tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/salivary-gland-cancer/diagnosis-treatment/drc-20354155

  Treatment for salivary gland tumors usually involves surgery to remove the tumor. People with salivary gland cancers may need additional treatments. These additional treatments can include radiation therapy, chemotherapy, targeted therapy or immunotherapy. […] Surgery for salivary gland tumors may include: […] Removing part of the affected salivary gland. If your tumor is small and located in an easy-to-access spot, your surgeon may remove the tumor and a small portion of healthy tissue around it. […] Removing the entire salivary gland. If you have a larger tumor, your surgeon may recommend removing the entire salivary gland. If your tumor extends into nearby structures, they also may be removed. Nearby structures may include the facial nerves, the ducts that connect the salivary glands, facial bones and skin.

• #10 Parotidectomy (Parotid Gland Tumor Surgery) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/salivary-gland/salivary-gland-cancer-treatment/parotidectomy-parotid-gland-tumor-surgery

  In some cases, the facial nerve may be temporarily or, very rarely, permanently weakened due to removal of a parotid gland tumor. The risk of facial nerve weakness is directly related to the size, extent, and type of parotid gland tumor. […] Our reconstructive surgeons have developed highly specialized techniques for treating facial paralysis so patients with parotid gland tumors can regain movement after treatment. […] By transferring or transplanting muscles and nerves from other parts of the body or rewiring nerves, our surgeons can restore movement within months. This procedure is known as facial reanimation. It may be done when the tumor is being removed or even years after treatment in some cases. […] We also offer an innovative method for facial reanimation called the dual-babysitter technique. It involves rewiring nerves from both the tongue and biting muscle to the facial muscles, in combination with nerve grafts. This approach has helped reawaken muscular function and further improved the ability of people to smile and close their eyes.

• #11 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from sources such as X-rays and protons. […] Radiation therapy is used to treat parotid gland cancers. Radiation therapy might be recommended after surgery. The radiation can kill any cancer cells that remain. If surgery isn’t possible, radiation therapy might be the first treatment for parotid cancers. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy is sometimes used to treat parotid gland cancers. It might be needed if there’s a risk that the cancer might spread or if surgery isn’t an option. In these situations, chemotherapy might be done at the same time as radiation therapy. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy might be an option for treating parotid gland cancers when other treatments haven’t helped.

• #12 Salivary Gland Cancer Treatment by Stage | Salivary Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/treating/by-stage.html

  Radiation therapy may be given after surgery if your cancer is intermediate- or high-grade or an adenoid cystic carcinoma, if the cancer could not be removed completely, if the cancer is invading nearby blood vessels, lymph vessels, or nerves; if the removed lymph nodes have cancer; or if the edges of the removed tissue contain cancer cells. […] Radiation therapy might be an option as the main treatment if surgery would result in serious problems with eating, speech, or appearance, or for people who refuse surgery. […] Doctors generally recommend extensive surgery (removing the salivary gland containing the tumor, nearby tissues, and lymph nodes in your neck on the same side) if its possible. […] But in other cases, especially for high-grade tumors or adenoid cystic cancer, surgery is often followed by radiation therapy.

• #13 Salivary Gland Cancer – Head and Neck Cancer Australia

  https://www.headandneckcancer.org.au/types-of-head-neck-cancer/salivary-gland-cancer/

  The most common approach of radiation therapy for Salivary Gland Cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body. […] Radiation therapy can be used in the following ways: Definitive – This is when radiation therapy is used on its own without surgery to cure Salivary Gland Cancer. It is used in Salivary Gland Cancer when surgery is not a treatment option. […] Adjuvant – This is when radiation therapy is given after surgery, to kill cancer cells that may not have been taken out during surgery. It can be used either on its own or at the same time as chemotherapy (chemoradiation), to make it more effective. The decision to give radiation therapy, either alone or with chemotherapy, is based on the pathology results after surgery. The aim of adjuvant radiation therapy is to reduce the risk of Salivary Gland Cancer coming back. Not everyone will require adjuvant radiation therapy.

• #14 Salivary Gland Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/head-and-neck/hp/adult/salivary-gland-treatment-pdq

  The minimum therapy for patients with low-grade malignancies of the superficial portion of the parotid gland is a superficial parotidectomy. For all other lesions, a total parotidectomy is often indicated. The facial nerve or its branches should be resected if involved by tumor; repair can be done simultaneously. Evidence suggests that postoperative radiation therapy augments surgical resection, particularly for the high-grade neoplasms, when margins are close or involved, when tumors are large, or when histological evidence of lymph node metastases is present. […] Fast neutron-beam radiation therapy or accelerated hyperfractionated photon-beam schedules have been effective in the treatment of inoperable, unresectable, and recurrent tumors. […] Postoperative radiation therapy may improve local control and increase survival rates for patients with high-grade tumors, positive surgical margins, or perineural invasion. […] Patients with inoperable, unresectable, or recurrent malignant salivary gland tumors treated with fast neutron-beam radiation therapy have better disease-free survival and overall survival than patients treated with conventional x-ray radiation therapy.

• #15 logo–sylvester

  https://umiamihealth.org/en/sylvester-comprehensive-cancer-center/treatments-and-services/head-and-neck-cancers/salivary-gland-cancer

  Most salivary gland tumors grow in the parotid gland. The facial nerve that controls movement on the same side of the face passes through this gland. It is very important for such a surgery to be done at a skilled center like Sylvester. […] Radiation therapy may be used as the main treatment (alone or with chemotherapy) for some salivary gland cancers that can’t be removed by surgery. It may be used after surgery, or with chemotherapy, when cancer is aggressive, or in people with advanced salivary gland cancer. […] Chemotherapy is not often used to treat salivary gland cancers. Some doctors may use it along with radiation therapy to try to make the radiation more effective. More often, it is used in patients whose cancer has spread (metastasized) to distant organs and in patients whose cancers could not be controlled by surgery and radiation therapy.

• #16 Salivary Gland Cancer – Head and Neck Cancer Australia

  https://www.headandneckcancer.org.au/types-of-head-neck-cancer/salivary-gland-cancer/

  Palliative – In cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced Salivary Gland Cancer. Symptoms that may require palliative radiation therapy include pain, bleeding, breathing and trouble swallowing. […] Chemotherapy works by destroying or damaging cancer cells. For Salivary Gland Cancer, it is usually given into a vein through a needle with a cannula (tube) attached. […] There are a number of ways that chemotherapy may be used to treat Salivary Gland Cancer including: Adjuvant – This is when chemotherapy is given after surgery and is usually combined with radiation therapy (chemoradiation). It is usually given once a week during radiation therapy. Adding chemotherapy makes the radiation more effective at destroying cancer cells, but also leads to increased side effects for most patients.

• #17 Treatment for Salivary Gland Cancer | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/salivary-gland-cancer/treatment.html

  If you need surgery to remove cancer from this gland, our surgeons will use techniques to operate on the gland without damaging the nerve, if at all possible. […] This may be the best option for some patients. […] UW Medical Center is one of three facilities in the United States to offer neutron therapy, an especially powerful kind of radiation therapy shown to be effective against salivary gland tumors and some other forms of cancer. […] When salivary gland tumors are detected early, the standard treatment is surgical resection, or removal. […] Our surgeons use surgical techniques designed to spare the facial nerve, explains Laramore. […] Neutron therapy is especially good at controlling salivary gland cancer at the tumor site and in the same region. […] Neutron therapy can be used to treat cancer in areas other than the salivary glands as well. […] Neutron therapy uses beams of neutrons to attack cancer cells. […] Neutron therapy is a good choice in some cases when tumors are resistant to regular radiation. […] The side effects from neutron therapy are similar to those from regular radiation therapy but may be more intense.

• #18 Salivary Gland Neoplasms Treatment & Management: Medical Therapy, Surgical Therapy, Intraoperative Details

  https://emedicine.medscape.com/article/852373-treatment

  Medical Therapy […] In general, salivary gland neoplasms respond poorly to chemotherapy, and adjuvant chemotherapy is currently indicated only for palliation. […] Platinum-based agents, in combination with mitoxantrone or vinorelbine, are also effective in controlling recurrent salivary gland malignancy. […] A new form of 5-fluorouracil called fluoropyrimidine that has increased activity against malignant cells and while having fewer gastrointestinal side effects has shown to be efficacious against malignant salivary cancers and to potentiate the effects of radiotherapy by increasing apoptosis. […] Radiotherapy is rarely the definitive treatment modality for salivary gland neoplasms, being used alone usually for tumors that are considered nonresectable. […] The use of radiation in T1 and T2 parotid gland tumors found that 5-year disease-free survival increased from 70% to 92% with postoperative radiation. […] A second study investigated postresection radiotherapy for carcinoma ex pleomorphic adenoma and found a 26% improvement in 5-year local control (from 49% to 75%).

• #19 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from sources such as X-rays and protons. […] Radiation therapy is used to treat parotid gland cancers. Radiation therapy might be recommended after surgery. The radiation can kill any cancer cells that remain. If surgery isn’t possible, radiation therapy might be the first treatment for parotid cancers. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy is sometimes used to treat parotid gland cancers. It might be needed if there’s a risk that the cancer might spread or if surgery isn’t an option. In these situations, chemotherapy might be done at the same time as radiation therapy. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy might be an option for treating parotid gland cancers when other treatments haven’t helped.

• #20 Chemotherapy for Salivary Gland Cancer | NYU Langone Health

  https://nyulangone.org/conditions/salivary-gland-cancer/treatments/chemotherapy-for-salivary-gland-cancer

  Doctors at NYU Langone may use chemotherapy, in which a group of drugs is used to destroy cancer cells throughout the body, in combination with radiation therapy to manage salivary gland cancer. This approach, called chemoradiation, may be used after surgery to eliminate any remaining cancer cells, especially if the salivary gland cancer was growing rapidly. […] If salivary gland cancer has spread to other parts of the body, such as the lungs, doctors may prescribe chemotherapy alone. […] Chemotherapy can make cancer cells more sensitive to radiation therapy, which is why both approaches may be used at the same time to manage salivary gland cancer. Doctors may use chemoradiation if salivary gland cancer is aggressive or if it has spread to important nerves or the lymph nodes in the neck.

• #21 Salivary Gland Neoplasms Treatment & Management: Medical Therapy, Surgical Therapy, Intraoperative Details

  https://emedicine.medscape.com/article/852373-treatment

  Medical Therapy […] In general, salivary gland neoplasms respond poorly to chemotherapy, and adjuvant chemotherapy is currently indicated only for palliation. […] Platinum-based agents, in combination with mitoxantrone or vinorelbine, are also effective in controlling recurrent salivary gland malignancy. […] A new form of 5-fluorouracil called fluoropyrimidine that has increased activity against malignant cells and while having fewer gastrointestinal side effects has shown to be efficacious against malignant salivary cancers and to potentiate the effects of radiotherapy by increasing apoptosis. […] Radiotherapy is rarely the definitive treatment modality for salivary gland neoplasms, being used alone usually for tumors that are considered nonresectable. […] The use of radiation in T1 and T2 parotid gland tumors found that 5-year disease-free survival increased from 70% to 92% with postoperative radiation. […] A second study investigated postresection radiotherapy for carcinoma ex pleomorphic adenoma and found a 26% improvement in 5-year local control (from 49% to 75%).

• #22 Chemotherapy for Salivary Gland Cancer | NYU Langone Health

  https://nyulangone.org/conditions/salivary-gland-cancer/treatments/chemotherapy-for-salivary-gland-cancer

  Most chemotherapy drugs are given through a vein with intravenous (IV) infusion on a treatment schedule called a cycle. Cisplatin, carboplatin, and doxorubicin are a few of the drugs used to manage salivary gland cancer. When chemotherapy and radiation therapy are combined, medical oncologists and radiation oncologists work together to determine a personalized treatment schedule for you. […] A typical chemoradiation schedule involves giving a chemotherapy drug once a week throughout the six to seven weeks of radiation therapy. […] If salivary gland cancer has spread throughout the body, doctors may prescribe chemotherapy alone. This approach may help shrink the cancer and control pain, but it does not completely destroy the tumors. […] If you are receiving chemotherapy alone, treatment may occur once a week or once every three weeks, so you can rest and recover between cycles. You may receive several cycles of chemotherapy, helping relieve symptoms. The duration and number of cycles may vary from person to person.

• #23 Chemotherapy for Salivary Gland Cancer | NYU Langone Health

  https://nyulangone.org/conditions/salivary-gland-cancer/treatments/chemotherapy-for-salivary-gland-cancer

  Most chemotherapy drugs are given through a vein with intravenous (IV) infusion on a treatment schedule called a cycle. Cisplatin, carboplatin, and doxorubicin are a few of the drugs used to manage salivary gland cancer. When chemotherapy and radiation therapy are combined, medical oncologists and radiation oncologists work together to determine a personalized treatment schedule for you. […] A typical chemoradiation schedule involves giving a chemotherapy drug once a week throughout the six to seven weeks of radiation therapy. […] If salivary gland cancer has spread throughout the body, doctors may prescribe chemotherapy alone. This approach may help shrink the cancer and control pain, but it does not completely destroy the tumors. […] If you are receiving chemotherapy alone, treatment may occur once a week or once every three weeks, so you can rest and recover between cycles. You may receive several cycles of chemotherapy, helping relieve symptoms. The duration and number of cycles may vary from person to person.

• #24 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from sources such as X-rays and protons. […] Radiation therapy is used to treat parotid gland cancers. Radiation therapy might be recommended after surgery. The radiation can kill any cancer cells that remain. If surgery isn’t possible, radiation therapy might be the first treatment for parotid cancers. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy is sometimes used to treat parotid gland cancers. It might be needed if there’s a risk that the cancer might spread or if surgery isn’t an option. In these situations, chemotherapy might be done at the same time as radiation therapy. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy might be an option for treating parotid gland cancers when other treatments haven’t helped.

• #25 Targeted cancer drugs for salivary gland cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/salivary-gland-cancer/treatment/targeted

  Targeted drugs work by targeting the differences in cancer cells that help them to grow and survive. They are a treatment for salivary gland cancer when the cancer has spread or other treatments stop working. […] You might have one of these treatments if your salivary gland cancer has a gene change (mutation) or a certain protein that helps the cancer grow. This may be as part of a clinical trial. […] Targeted drugs can help some people with advanced salivary gland cancer. Although these treatments cant cure the cancer, they may help to control it for a time and help some people to live longer. […] If your cancer has an NTRK gene change then you might have the following targeted cancer drugs: larotrectinib (Vitrakvi) and entrectinib (Rozlytrek). […] Certain drugs can target HER2 positive cancers. If you have HER2 positive salivary gland cancer that is advanced or has come back after previous treatment you might have: trastuzumab and pertuzumab.

• #26

  https://link.springer.com/article/10.1007/s12254-020-00614-z

  The aim of this review is to recapitulate treatment options for ACC and non-ACC, especially focusing on targeted therapies which are already available for subsets of SGCs. […] Active agents that were tested mainly in phase II studies include cisplatin, mitoxantron, epirubicin and vinorelbine. […] Combination therapy with cisplatin, doxorubicin and cyclophosphamide (CAP) provided overall response rates (ORR) between 18-33% in a total of 4 studies. […] A doublet therapy consisting of cisplatin and an anthracycline leads to ORR of roughly 25%. […] Given the fact that chemotherapy has only limited efficacy in ACC, approaches targeting molecular targets were investigated. […] Recently, lenvatinib showed modest activity in a phase II trial of 33 previously treated patients with ACC. […] In the absence of driver mutations, chemotherapy can be offered to these patients.

• #27 Targeted cancer drugs for salivary gland cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/salivary-gland-cancer/treatment/targeted

  Targeted drugs work by targeting the differences in cancer cells that help them to grow and survive. They are a treatment for salivary gland cancer when the cancer has spread or other treatments stop working. […] You might have one of these treatments if your salivary gland cancer has a gene change (mutation) or a certain protein that helps the cancer grow. This may be as part of a clinical trial. […] Targeted drugs can help some people with advanced salivary gland cancer. Although these treatments cant cure the cancer, they may help to control it for a time and help some people to live longer. […] If your cancer has an NTRK gene change then you might have the following targeted cancer drugs: larotrectinib (Vitrakvi) and entrectinib (Rozlytrek). […] Certain drugs can target HER2 positive cancers. If you have HER2 positive salivary gland cancer that is advanced or has come back after previous treatment you might have: trastuzumab and pertuzumab.

• #28 Treatments for Tumors or Growths in a salivary glands | DoctorLansford.com

  https://www.doctorlansford.com/treatments-salivary-tumors

  Immunotherapy is treatment with medicines to boost a persons own immune system to recognize and destroy cancer cells more effectively. Immunotherapy, such as pembrolizumab (Keytruda), may be used for advanced salivary gland cancers, especially when other treatment types have been utilized and/or when no other good option exists.

• #29 Salivary Gland Cancer: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17965-salivary-gland-cancer

  Chemotherapy uses drugs to destroy cancer cells. You may receive chemotherapy if your cancer has spread from your salivary glands to other tissues outside of your head and neck. […] Your healthcare provider may recommend that you participate in a clinical trial. A clinical trial is research that studies the safety and effectiveness of new treatments. […] Immunotherapy uses drugs to help your immune system identify cancer cells and fight them. Researchers are studying the role of a specific type of immunotherapy called checkpoint inhibitors in fighting metastasized cancer. […] Targeted therapy uses drugs that target weaknesses in a cancer cells genetic code (DNA) to destroy the cancer or stop it from growing. Researchers are studying the effectiveness of targeted therapies in people with adenoid cystic carcinomas that have metastasized.

• #30 Benign Tumors of Major Salivary Glands Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/194357-treatment

  Experienced clinicians generally agree that surgical excision is indicated for all patients in whom a salivary gland mass develops, unless comorbid medical problems preclude such intervention. Ultimately, surgical excision permits definitive diagnosis and determines the need for any adjuvant therapy that may be indicated in malignant tumors. […] Furthermore, surgery is recommended in view of the unique consequences that can arise from even a benign space-occupying mass or tumor in the head and neck region, specifically related to loss of function, disfigurement, and the psychosocial ramifications of such issues. […] Management of benign SGTs includes complete removal of the neoplasm with an adequate margin of tissue to avoid recurrence. This usually involves either complete removal of the gland in which the tumor developed or extracapsular dissection of the tumor within the affected gland.

• #31 Benign Tumors of Major Salivary Glands Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/194357-treatment

  Superficial parotidectomy remains the initial procedure of choice for benign parotid gland tumors. […] Extracapsular dissection may also be performed as an alternative to superficial parotidectomy so as to minimize associated morbidity and potentially reduce operating times. […] Recurrence of a benign tumor can be avoided with complete excision of the lesion. Enucleation should be avoided so as to minimize the chance of tumor spillage and seeding recurrence.

• #32 Salivary Gland Tumors – What You Need To Know – American Head & Neck Society

  https://www.ahns.info/salivary-gland/sg-tumors-what-you-need-to-know/

  Most benign salivary gland tumors are removed with surgery. Surgical removal makes sure that the tumor is not cancer and treats discomfort or cosmetic changes from tumor growth. Surgery is usually done in the operating room under general anesthesia. The extent and complexity of surgery will depend on the location and size of the tumor. In general, the tumor is removed with a small amount of normal gland tissue around it to make sure that it does not grow back. […] If surgery is not possible, or if a person has health issues that make going under anesthesia risky, then observation may be ok for certain benign tumors. Imaging may be used to follow a tumor over time, to watch for growth. […] Rarely, radiation may be used for a benign salivary tumor if surgery or observation are not feasible. In recurrent pleomorphic adenoma that cannot be removed safely, radiation may be considered.

• #33 Salivary Gland Cancer Treatment by Stage | Salivary Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/treating/by-stage.html

  The treatment options for salivary gland cancer depend largely on the type and stage (extent) of the cancer. But other factors, such as the grade of the cancer (how likely it is to grow and spread); and a persons overall health, can also be important. […] Since salivary gland cancers are rare and can be hard to treat, clinical trials might be a good option to think about. […] If you have stage I salivary gland cancer, your doctors will probably recommend surgery to remove the cancer and part or all of the salivary gland. […] Radiation therapy might be advised after surgery if you have an intermediate- or high-grade cancer or an adenoid cystic carcinoma, if the cancer could not be removed completely, if the edges of the removed area have cancer cells (a sign that some cancer might have been left behind), or if the cancer is invading (growing into) nearby nerves.

• #34 Salivary Gland Neoplasms Treatment & Management: Medical Therapy, Surgical Therapy, Intraoperative Details

  https://emedicine.medscape.com/article/852373-treatment

  On the basis of the histologic classification and clinical stage, a useful management schema has been developed. […] Group 1 includes T1 and T2 low-grade tumors (eg, low-grade mucoepidermoid carcinoma, acinic cell carcinoma). […] For these tumors, perform parotidectomy (superficial or total) with an adequate margin of normal tissue with preservation of the facial nerve. […] For complete excision without tumor spillage and no evidence of cervical metastases, radiation therapy is not performed. […] Group 2 includes T1 and T2 tumors with high-grade features (eg, high-grade mucoepidermoid carcinoma, adenoid cystic carcinoma, squamous cell carcinoma, adenocarcinoma, carcinoma ex-pleomorphic adenoma). […] For these tumors, perform total parotidectomy, including the first-echelon lymph nodes. […] Administer postoperative radiation therapy to the parotid region and the neck.

• #35 Salivary Gland Neoplasms Treatment & Management: Medical Therapy, Surgical Therapy, Intraoperative Details

  https://emedicine.medscape.com/article/852373-treatment

  On the basis of the histologic classification and clinical stage, a useful management schema has been developed. […] Group 1 includes T1 and T2 low-grade tumors (eg, low-grade mucoepidermoid carcinoma, acinic cell carcinoma). […] For these tumors, perform parotidectomy (superficial or total) with an adequate margin of normal tissue with preservation of the facial nerve. […] For complete excision without tumor spillage and no evidence of cervical metastases, radiation therapy is not performed. […] Group 2 includes T1 and T2 tumors with high-grade features (eg, high-grade mucoepidermoid carcinoma, adenoid cystic carcinoma, squamous cell carcinoma, adenocarcinoma, carcinoma ex-pleomorphic adenoma). […] For these tumors, perform total parotidectomy, including the first-echelon lymph nodes. […] Administer postoperative radiation therapy to the parotid region and the neck.

• #36 Salivary Gland Neoplasms Treatment & Management: Medical Therapy, Surgical Therapy, Intraoperative Details

  https://emedicine.medscape.com/article/852373-treatment

  Group 3 tumors generally require radical parotidectomy with sacrifice of the facial nerve in order to obtain sufficient tumor-free margins. […] Perform neck dissection for positive nodal disease and treat the parotid bed and neck with postoperative radiation therapy. […] Group 4 tumors require wide surgical extirpation to fit the tumor extent. […] Neck dissection and postoperative radiation therapy are added for these tumors.

• #37 Salivary Gland Cancer Treatment (Adult) | Vanderbilt-Ingram Cancer Center

  https://vicc.org/cancer-info/adult-salivary-gland-cancer-treatment-adult

  Treatment of stage III salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing). […] Treatment of stage IVA, stage IVB, and stage IVC salivary gland cancer may include the following: Fast neutron or photon-beam radiation therapy, A clinical trial of chemotherapy with or without radiation therapy. […] Treatment of recurrent salivary gland cancer may include the following: Radiation therapy, A clinical trial of a new treatment.

• #38 Salivary Gland Cancer Treatment by Stage | Salivary Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/treating/by-stage.html

  Radiation therapy (with or without chemo) may be used as the main treatment if surgery is not a good option (for example, if surgical removal of the cancer would cause serious problems with eating, speech, or appearance, or if someone is not healthy enough to have surgery). […] Some of these cancers might be treated with surgery if the doctor feels all of the cancer can be removed. (This would be followed by radiation therapy and maybe chemo.) […] But most often, radiation therapy is used as the main treatment to try to shrink the tumor(s) and relieve pain, bleeding, or other symptoms. […] If cancer returns after treatment, your choices depend on the location and the extent of the cancer as well as what treatment was used the first time. […] If the cancer recurs locally and is thought to be resectable (able to be removed completely), surgery is usually the treatment of choice.

• #39 Treatments for recurrent salivary gland cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/salivary-gland/treatment/recurrent

  Recurrent salivary gland cancer means that the cancer has come back after it has been treated. You may be offered the following treatments for recurrent salivary gland cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. […] External radiation therapy may be offered for recurrent salivary gland cancer. It can’t be used if you’ve already had radiation therapy in the area where the cancer has returned. […] Surgery may be offered for recurrent salivary gland cancer if it can safely be removed without causing problems with speaking and eating or changes to your appearance. It may also sometimes be used to remove a single metastasis in the lung or brain. […] Chemotherapy may be offered for recurrent salivary gland cancer if the person is healthy enough to have treatment. The type of chemotherapy drugs given will depend on what drugs you have already had for treatment.

• #40 Salivary Gland Cancer Treatment by Stage | Salivary Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/treating/by-stage.html

  The treatment options for salivary gland cancer depend largely on the type and stage (extent) of the cancer. But other factors, such as the grade of the cancer (how likely it is to grow and spread); and a persons overall health, can also be important. […] Since salivary gland cancers are rare and can be hard to treat, clinical trials might be a good option to think about. […] If you have stage I salivary gland cancer, your doctors will probably recommend surgery to remove the cancer and part or all of the salivary gland. […] Radiation therapy might be advised after surgery if you have an intermediate- or high-grade cancer or an adenoid cystic carcinoma, if the cancer could not be removed completely, if the edges of the removed area have cancer cells (a sign that some cancer might have been left behind), or if the cancer is invading (growing into) nearby nerves.

• #41 Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4873929/

  Ultrasound guided fine needle aspiration cytology is recommended for all salivary tumours and cytology should be reported by an expert histopathologist. (R) […] Adjuvant radiotherapy (RT) following surgery is recommended for all malignant submandibular tumours except in cases of small, low-grade tumours that have been completely excised. (R) […] For benign parotid tumours complete excision of the tumour should be performed and offers good cure rates. (R) […] As a general principle, if the facial nerve function is normal pre-operatively then every attempt to preserve facial nerve function should be made during parotidectomy and if the facial nerve is divided intra-operatively then immediate microsurgical repair (with an interposition nerve graft if required) should be considered. (G) […] Neck dissection is recommended in all cases of malignant parotid tumours except for low-grade small tumours. (R)

• #42 Support for Salivary Gland Cancer | NYU Langone Health

  https://nyulangone.org/conditions/salivary-gland-cancer/support

  Doctors, nurses, nurse practitioners, physician assistants, social workers, and rehabilitation specialists at NYU Langones Perlmutter Cancer Center and Rusk Rehabilitation collaborate to provide support for people with salivary gland cancer throughout diagnosis and treatment and during follow-up appointments. […] Speech and swallowing therapy may be used throughout treatment to preserve as much function as possible. It may also be given afterward to help you regain or compensate for any lost function. Therapy usually consists of exercises to strengthen the muscles in the tongue, mouth, vocal cords, and throat. […] If the facial nerve had to be sacrificed, all or part of the nerve can be reconstructed with nerve grafts to help restore facial muscle function. Surgeons may also reposition other muscles adjacent to the face or transfer muscles from other areas of the body. NYU Langone surgeons are experts at restoring as much function as possible.

• #43 Support for Salivary Gland Cancer | NYU Langone Health

  https://nyulangone.org/conditions/salivary-gland-cancer/support

  Radiation therapy and surgery for salivary gland cancer may cause muscle stiffness in the face, jaw, neck, and shoulders. Physical therapists and speech and swallowing therapists at Rusk Rehabilitation can teach you range-of-motion exercises, stretches, and relaxation techniques to help provide relief. […] Because salivary gland cancer treatment may cause difficulty with swallowing, you may need a nutritional assessment and dietary plan. Throughout your treatment and recovery, nutritionists at Perlmutter Cancer Center can help ensure you’re getting the nutrients you need in easy-to-swallow foods. […] A physiatrist can evaluate you and prescribe physical therapy at Rusk Rehabilitation. Physical therapy often includes range-of-motion and flexibility exercises. This is usually followed by specialized massage therapy to help the lymph fluid to drain.

• #44 Support for Salivary Gland Cancer | NYU Langone Health

  https://nyulangone.org/conditions/salivary-gland-cancer/support

  Doctors at Rusk Rehabilitation may prescribe medication to ease the discomfort of neuropathy. They can also prescribe physical therapy to help ensure that neuropathy doesn’t interfere with your balance, strength, or ability to walk and perform daily activities. […] If you are experiencing fatigue due to salivary gland cancer or its treatment, doctors may recommend physical and occupational therapy at Rusk Rehabilitation. This type of therapy may include strength and aerobic exercises to address fatigue caused by surgery, radiation therapy, or chemotherapy. […] Supportive care specialists at Perlmutter Cancer Center provide ongoing therapy for any cancer-related or treatment-related symptoms, such as pain, fatigue, loss of appetite, or stress, helping improve quality of life.

• #45 Salivary Gland Cancer | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/salivary-gland-cancer.html

  Depending on the stage of your salivary gland tumor and the effects its having on your body, your physician may recommend a combination of treatment options. […] For salivary gland cancer patients, this means more treatment options than you might find elsewhere, including the chance to participate in one of many ongoing clinical trials conducted at Fred Hutch and UW Medicine. […] Many patients at Fred Hutch receive promising therapies by taking part in clinical trials. […] Every advance in cancer treatment in recent years has come out of clinical trials. […] For some people, taking part in a clinical study may be the best treatment choice.

• #46 Targeted cancer drugs for salivary gland cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/salivary-gland-cancer/treatment/targeted

  A type of hormone treatment can attach to these receptors and stop the cancer from growing. These drugs are called anti androgens. […] If you have advanced or metastatic salivary gland cancer you might have anti androgen treatment. An example of an anti androgen is the drug bicalutamide. […] Researchers are trying to find better treatments for salivary gland cancer. This includes learning more about the genetic make-up of individual cancers and developing different types of targeted drugs and immunotherapies. […] You might be offered immunotherapy as part of a clinical trial.

• #47 5 innovative treatments for salivary gland cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/salivary-gland-cancer/salivary-gland-cancer-treatment.html

  For salivary gland cancer, radiation therapy is typically used after surgery to kill any remaining cancer cells. It is also used when surgery isn’t possible. […] Chemotherapy is not often used in salivary gland cancer, but it can be used in combination with radiation therapy in select cases. […] Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. […] Immune checkpoint inhibitors are only used in select cases. […] Regular follow-up and screenings are vital due to the high risk of salivary gland returning. Patients need to see their doctors every three to six months for the first two years after treatment, since most cancers that recur, or come back, do so within that time. […] Salivary gland patients are also strongly urged not to smoke or drink alcohol during and after treatment.

• #48 5 innovative treatments for salivary gland cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/salivary-gland-cancer/salivary-gland-cancer-treatment.html

  For salivary gland cancer, radiation therapy is typically used after surgery to kill any remaining cancer cells. It is also used when surgery isn’t possible. […] Chemotherapy is not often used in salivary gland cancer, but it can be used in combination with radiation therapy in select cases. […] Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. […] Immune checkpoint inhibitors are only used in select cases. […] Regular follow-up and screenings are vital due to the high risk of salivary gland returning. Patients need to see their doctors every three to six months for the first two years after treatment, since most cancers that recur, or come back, do so within that time. […] Salivary gland patients are also strongly urged not to smoke or drink alcohol during and after treatment.

• #49 5 innovative treatments for salivary gland cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/salivary-gland-cancer/salivary-gland-cancer-treatment.html

  For salivary gland cancer, radiation therapy is typically used after surgery to kill any remaining cancer cells. It is also used when surgery isn’t possible. […] Chemotherapy is not often used in salivary gland cancer, but it can be used in combination with radiation therapy in select cases. […] Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. […] Immune checkpoint inhibitors are only used in select cases. […] Regular follow-up and screenings are vital due to the high risk of salivary gland returning. Patients need to see their doctors every three to six months for the first two years after treatment, since most cancers that recur, or come back, do so within that time. […] Salivary gland patients are also strongly urged not to smoke or drink alcohol during and after treatment.

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