Département de radiothérapie, centre François-Baclesse, 3, avenue General-Harris, 14000 Caen, France; Service de radiothérapie, CHU de Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges, France.
Radiodiagnostic et radiologie interventionnelle, polyclinique Elsan, 332, avenue Frédéric-Mistral, 83190 Ollioules, France.
Cancer Radiother. 2022 Feb-Apr;26(1-2):213-220. doi: 10.1016/j.canrad.2021.08.012. Epub 2021 Dec 22.
Primary tumours of the salivary glands account for about 5 to 10% of tumours of the head and neck. These tumours represent a multitude of situations and histologies, where surgery is the mainstay of treatment and radiotherapy is frequently needed for malignant tumours (in case of stage T3-T4, nodal involvement, extraparotid invasion, positive or close resection margins, histological high-grade tumour, lymphovascular or perineural invasion, bone involvement postoperatively, or unresectable tumours). The diagnosis relies on anatomic and functional MRI and ultrasound-guided fine-needle aspiration for the diagnostic of benign or malignant tumors. In addition to patient characteristics, the determination of primary and nodal target volumes depends on tumor extensions and stage, histology and grade. Therefore, radiotherapy of salivary gland tumors requires a certain degree of personalization, which has been codified in the recommendations of the French multidisciplinary network of expertise for rare ENT cancers (Refcor) and may justify a specialised multidisciplinary discussion. Although radiotherapy is usually recommended for malignant tumours only, recurrent pleomorphic adenomas may sometimes require radiotherapy based on multidisciplinary discussion. An update of indications and recommendations for radiotherapy for salivary gland tumours in terms of techniques, doses, target volumes and dose constraints to organs at risk of the French society for radiotherapy and oncology (SFRO) was reported in this article.
唾液腺原发性肿瘤占头颈部肿瘤的 5%至 10%。这些肿瘤代表了多种情况和组织学类型，手术是主要的治疗方法，而恶性肿瘤通常需要放射治疗（T3-T4 期、淋巴结受累、腮腺外侵犯、切缘阳性或接近、组织学高级别肿瘤、脉管或神经周围侵犯、术后骨侵犯或不可切除的肿瘤）。诊断依赖于解剖和功能 MRI 以及超声引导下的细针抽吸术，用于诊断良性或恶性肿瘤。除了患者特征外，原发和淋巴结靶区的确定还取决于肿瘤的扩展和分期、组织学和分级。因此，唾液腺肿瘤的放射治疗需要一定程度的个体化，这在法国罕见耳鼻喉癌症多学科专业网络（Refcor）的建议中已经得到了规定，并可能需要进行专门的多学科讨论。尽管放射治疗通常仅推荐用于恶性肿瘤，但多形性腺瘤的复发有时可能需要根据多学科讨论进行放射治疗。本文报道了法国放射肿瘤学会（SFRO）在技术、剂量、靶区和危及器官剂量限制方面对唾液腺肿瘤放射治疗的适应证和建议进行了更新。
