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Salivary Gland Adjuvant RT — SCE Medical Oncology MCQ

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ModerateHead & Neck CancerSalivary Gland Adjuvant RTSCE Medical Oncology

A 55-year-old woman with salivary gland mucoepidermoid carcinoma (high-grade, T3 N0 M0) undergoes parotidectomy with facial nerve preservation. All margins are clear. What adjuvant therapy is recommended?

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Correct answer: E — Adjuvant radiotherapy — recommended for high-grade salivary gland carcinomas, T3-T4 tumours, close/positive margins, perineural invasion or lymph node involvement

Adjuvant radiotherapy (60-66 Gy) is recommended after surgery for salivary gland carcinomas with high-risk features: high grade, T3-T4 stage, positive/close margins, perineural invasion, lymphovascular invasion or nodal involvement. Adjuvant chemotherapy has no established role. Salivary gland carcinomas are a heterogeneous group (mucoepidermoid, adenoid cystic, acinic cell, salivary duct) with variable biology and molecular profiles (HER2 in salivary duct carcinoma, NTRK fusions in secretory carcinoma, MYB-NFIB in adenoid cystic).

Reference: NICE NG36; ESMO 2024 H&N Cancer; NCCN Salivary Gland Guidelines