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Abstract：
BACKGROUND: Because of the rarity, heterogeneous histology, and diverse anatomical sites of salivary gland cancer (SGC), there are a limited number of clinical studies on its management. This study reports the cumulative evidence of postoperative radiotherapy (PORT) for SGC of the head and neck.
METHODS: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases between 7th and 10th November 2023.
RESULTS: A total of 2962 patients from 26 studies between 2007 and 2023 were included in this meta-analysis. The median RT dose was 64 Gy (range: 56-66 Gy). The median proportions of high-grade, pathological tumor stage 3 or 4 and pathological lymph node involvement were 42% (0-100%), 40% (0-77%), and 31% (0-75%). The pooled locoregional control rates at 3, 5, and 10 years were 92% (95% confidence interval [CI], 89-94%), 89% (95% CI, 86-93%), and 84% (95% CI, 73-92%), respectively. The pooled disease-free survival (DFS) rates at 3, 5, and 10 years were 77% (95% CI, 70-83%), 67% (95% CI, 60-74%), and 61% (95% CI, 55-67%), respectively. The pooled overall survival rates at 3, 5, and 10 years were 84% (95% CI, 79-88%), 75% (95% CI, 72-79%), and 68% (95% CI, 62-74%), respectively. Severe late toxicity ≥ grade 3 occurred in 7% (95% CI, 3-14%).
CONCLUSIONS: PORT showed favorable long-term efficacy and safety in SGC, especially for patients with high-grade histology. Considering that DFS continued to decrease, further clinical trials exploring treatment intensification are warranted.
METHODS: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases between 7th and 10th November 2023.
RESULTS: A total of 2962 patients from 26 studies between 2007 and 2023 were included in this meta-analysis. The median RT dose was 64 Gy (range: 56-66 Gy). The median proportions of high-grade, pathological tumor stage 3 or 4 and pathological lymph node involvement were 42% (0-100%), 40% (0-77%), and 31% (0-75%). The pooled locoregional control rates at 3, 5, and 10 years were 92% (95% confidence interval [CI], 89-94%), 89% (95% CI, 86-93%), and 84% (95% CI, 73-92%), respectively. The pooled disease-free survival (DFS) rates at 3, 5, and 10 years were 77% (95% CI, 70-83%), 67% (95% CI, 60-74%), and 61% (95% CI, 55-67%), respectively. The pooled overall survival rates at 3, 5, and 10 years were 84% (95% CI, 79-88%), 75% (95% CI, 72-79%), and 68% (95% CI, 62-74%), respectively. Severe late toxicity ≥ grade 3 occurred in 7% (95% CI, 3-14%).
CONCLUSIONS: PORT showed favorable long-term efficacy and safety in SGC, especially for patients with high-grade histology. Considering that DFS continued to decrease, further clinical trials exploring treatment intensification are warranted.
摘要：
背景：由于稀有，异质性组织学，和唾液腺癌（SGC）的不同解剖部位，关于其管理的临床研究数量有限。本研究报告了头颈部SGC术后放疗（PORT）的累积证据。
方法：根据系统评价和荟萃分析指南的首选报告项目进行系统评价。我们搜查了PubMed,Embase,科克伦图书馆,和2023年11月7日至10日之间的WebofScience数据库。
结果：这项荟萃分析纳入了2007年至2023年之间26项研究的2962名患者。中位RT剂量为64Gy(范围:56-66Gy)。高档的中位数比例，病理肿瘤3期或4期及病理淋巴结受累占42%(0-100%),40%（0-77%），和31%（0-75%）。3、5和10年的合并局部控制率为92%(95%置信区间[CI]，89-94%），89%（95%CI，86-93%），和84%（95%CI，73-92%），分别。3、5和10年的合并无病生存率（DFS）为77％（95％CI，70-83％），67%（95%CI，60-74%），和61%（95%CI，55-67%），分别。3、5和10年的合并总生存率为84％（95％CI，79-88％），75%（95%CI，72-79%），和68%（95%CI，62-74%），分别。严重晚期毒性≥3级发生率为7%(95%CI,3-14%)。
结论：PORT在SGC中显示出良好的长期疗效和安全性，特别是对于组织学分级高的患者。考虑到外勤部继续减少，进一步探索强化治疗的临床试验是必要的.
方法：根据系统评价和荟萃分析指南的首选报告项目进行系统评价。我们搜查了PubMed,Embase,科克伦图书馆,和2023年11月7日至10日之间的WebofScience数据库。
结果：这项荟萃分析纳入了2007年至2023年之间26项研究的2962名患者。中位RT剂量为64Gy(范围:56-66Gy)。高档的中位数比例，病理肿瘤3期或4期及病理淋巴结受累占42%(0-100%),40%（0-77%），和31%（0-75%）。3、5和10年的合并局部控制率为92%(95%置信区间[CI]，89-94%），89%（95%CI，86-93%），和84%（95%CI，73-92%），分别。3、5和10年的合并无病生存率（DFS）为77％（95％CI，70-83％），67%（95%CI，60-74%），和61%（95%CI，55-67%），分别。3、5和10年的合并总生存率为84％（95％CI，79-88％），75%（95%CI，72-79%），和68%（95%CI，62-74%），分别。严重晚期毒性≥3级发生率为7%(95%CI,3-14%)。
结论：PORT在SGC中显示出良好的长期疗效和安全性，特别是对于组织学分级高的患者。考虑到外勤部继续减少，进一步探索强化治疗的临床试验是必要的.
