TY - JOUR
T1 - Management algorithm for HIV-associated parotid lymphoepithelial cysts
AU - Mourad, Waleed F.
AU - Patel, Shyamal
AU - Young, Rebekah
AU - Khorsandi, Azita S.
AU - Concert, Catherine
AU - Shourbaji, Rania A.
AU - Ciarrocca, Katherine
AU - Bakst, Richard L.
AU - Shasha, Daniel
AU - Guha, Chandan
AU - Garg, Madhur K.
AU - Hu, Kenneth S.
AU - Kalnicki, Shalom
AU - Harrison, Louis B.
N1 - Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - We report an evidence-based management algorithm for benign lymphoepithelial cysts (BLEC) of the parotid glands in HIV patients based on long-term outcomes after radiation therapy. From 1987 to 2013, 72 HIV-positive patients with BLEC of the parotid glands treated at our institutions were identified and their medical records were reviewed and analyzed. The primary endpoint of our study was to determine a dose response in HIV patients with BLEC. In group A (≤18 Gy), which received a median dose of 10 Gy (8–18), overall response (OvR), complete response (CR), partial response (PR), and local failure (LF) was experienced by 7, 7, 0, and 93 %, respectively. In group B (≥22.5 Gy), which received a median dose of 24 Gy (22.5–30), OvR, CR, PR, and LF was experienced by 88, 65, 23, and 12 %. Logistic regression revealed that higher dose (≥22.5 Gy) predicted for cosmetic control (p = 0.0003). Multiple regression analysis revealed higher dose predicted for cosmetic control (p = 0.0001) after adjusting for confounding variables (age, gender, race, HAART use, BLEC duration, and fractionation size). No patients in either group experienced RTOG grade ≥3 toxicities. A radiation dose of 24 Gy delivered in 12–16 fractions of 1.5–2 Gy per fraction provides long-term cosmetic control in HIV-positive patients with BLEC of the parotid glands.
AB - We report an evidence-based management algorithm for benign lymphoepithelial cysts (BLEC) of the parotid glands in HIV patients based on long-term outcomes after radiation therapy. From 1987 to 2013, 72 HIV-positive patients with BLEC of the parotid glands treated at our institutions were identified and their medical records were reviewed and analyzed. The primary endpoint of our study was to determine a dose response in HIV patients with BLEC. In group A (≤18 Gy), which received a median dose of 10 Gy (8–18), overall response (OvR), complete response (CR), partial response (PR), and local failure (LF) was experienced by 7, 7, 0, and 93 %, respectively. In group B (≥22.5 Gy), which received a median dose of 24 Gy (22.5–30), OvR, CR, PR, and LF was experienced by 88, 65, 23, and 12 %. Logistic regression revealed that higher dose (≥22.5 Gy) predicted for cosmetic control (p = 0.0003). Multiple regression analysis revealed higher dose predicted for cosmetic control (p = 0.0001) after adjusting for confounding variables (age, gender, race, HAART use, BLEC duration, and fractionation size). No patients in either group experienced RTOG grade ≥3 toxicities. A radiation dose of 24 Gy delivered in 12–16 fractions of 1.5–2 Gy per fraction provides long-term cosmetic control in HIV-positive patients with BLEC of the parotid glands.
KW - AIDS
KW - Benign lymphoepithelial cysts
KW - HAART
KW - HIV
KW - Parotid gland
KW - Radiation therapy
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U2 - 10.1007/s00405-016-3926-4
DO - 10.1007/s00405-016-3926-4
M3 - Article
C2 - 26879995
AN - SCOPUS:84958258809
SN - 0937-4477
VL - 273
SP - 3355
EP - 3362
JO - European Archives of Oto-Rhino-Laryngology
JF - European Archives of Oto-Rhino-Laryngology
IS - 10
ER -
