Radiotherapy for Polymorphous Low-grade Adenocarcinoma of the Head and Neck

Objective: To review the clinical course and outcome of patients who underwent radiotherapy (RT) for polymorphous low-grade adenocarcinoma (PLGA) of the head and neck. Methods: Medical records of patients who underwent RT for PLGA of the head and neck at our institution between June 1993 and March 2013 were reviewed. Results: Two men and two women aged 43 to 76 years who underwent primary (n = 1) or postoperative (n = 3) RT for PLGA of the oropharynx (n = 2) or oral cavity (n = 2) were reviewed. Three patients underwent resection and postoperative RT, and one patient with a hard palate tumour involving the pterygoid plate underwent RT alone. Intensity-modulated RT (n = 2) or 3-dimensional RT (n = 2) was performed with dose ranging from 60 to 79.2 Gy in 30 fractions once daily (n = 1) to 60-66 fractions twice daily (n = 3). Patients were followed up for 13 months to 9.5 years. Disease-free local control was achieved in those three patients with both surgery and postoperative RT. The patient treated with RT alone had recurrence and subsequently died of disease progression. No patient developed severe acute or late treatment-related toxicity. Conclusion: Postoperative RT may improve local control of PLGA in patients with close or positive margins after surgery.

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