Treatment difficulties in salivary gland cancer

Abstract Salivary gland cancers are represented by a heterogeneous histologic group of tumors, with low incidence, which may appear both in major and minor salivary glands. This article presents a review of the difficulties which may be encountered in this pathology during the treatment. The diagnosis of salivary gland cancers is often delayed, due to the histopathologic and immunohistochemistry results given in different period of times. There can be several difficulties in following the oncologic pre-treatment protocols, in terms of imaging technique, as MRI, useful for disease staging. The treatment of salivary gland cancers is complex, due to the local anatomy and their aggressive potential. Because of their decreased incidence, there are few data that investigate the treatment in the case of these diseases. The current therapy available for the patients with salivary gland cancers is represented by complete surgical resection. Several treatment difficulties in cancers of the salivary glands may come from the surgical limitations and the insufficient data for adjuvant and palliative treatment. Due to the limitations of the local health system, there is a heterogeneous distribution of the oncologic centers, lack of equipment, prolonged time to follow general protocols, despite the aspect of case-individualized therapy according to the guidelines. We must not forget the tumor behaviour and individual reactivity of different patients to the same treatment protocol.

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Systemic Therapy in the Palliative Management of Advanced Salivary Gland Cancers

Journal of Clinical Oncology ◽

10.1200/jco.2005.05.3025 ◽

2006 ◽

Vol 24 (17) ◽

pp. 2673-2678 ◽

Cited By ~ 186

Author(s):

Scott A. Laurie ◽

Lisa Licitra

Keyword(s):

Salivary Gland ◽

Systemic Therapy ◽

Potential Role ◽

Wide Spectrum ◽

Salivary Gland Cancer ◽

Molecular Characteristics ◽

Low Grade ◽

Few Data ◽

Systemic Therapies

Cancers of the salivary glands are unusual lesions that vary widely in their histologic appearance and molecular characteristics. Likewise, there is a wide spectrum of biologic behavior, ranging from low-grade, minimally invasive tumors, to highly lethal malignancies. There are few data on the role of systemic therapies in the management of these cancers, and chemotherapy is generally reserved for the palliative management of advanced disease that is not amenable to local therapies such as surgery and/or radiation. The majority of patients for whom systemic therapy is considered will have either adenoid cystic carcinoma, mucoepidermoid carcinoma, or high-grade adenocarcinoma. This article will review the available literature regarding the use of palliative chemotherapy for patients with advanced salivary gland cancer of these histologies, with an emphasis on the potential role of targeted agents. There is a need for a determined, coordinated effort to conduct high-quality clinical trials in patients with these rare cancers.

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A giant submandibular sialolith - How to manage?

South African Dental Journal ◽

10.17159/2519-0105/2020/v75no7a7 ◽

2020 ◽

Vol 75 (7) ◽

pp. 387-390

Author(s):

Jawahar Anand ◽

Amal Suresh ◽

Anil K Desai

Keyword(s):

Salivary Gland ◽

Case Report ◽

Salivary Glands ◽

Severe Pain ◽

Treatment Protocol ◽

Floor Of The Mouth ◽

Common Diseases ◽

Submandibular Salivary Glands ◽

History Of

The presence of a sialolith is one of the most common diseases of salivary gland. It is relatively common in submandibular salivary glands and its duct. This case report is of a patient who presented at our unit with a history of severe pain and swelling on floor of the mouth, which was clinically and radiographically diagnosed as a sialolith. The diagnostic and treatment protocol in managing a patient with a giant sialolith is enumerated in this manuscript.

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Salivary Gland Trauma: A Review of Diagnosis and Treatment

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0032-1313356 ◽

2012 ◽

Vol 5 (4) ◽

pp. 189-195 ◽

Cited By ~ 19

Author(s):

Maria Lazaridou ◽

Christos Iliopoulos ◽

Kostas Antoniades ◽

Ioannis Tilaveridis ◽

Ioannis Dimitrakopoulos ◽

...

Keyword(s):

Salivary Gland ◽

Early Diagnosis ◽

Parotid Gland ◽

Treatment Outcomes ◽

Salivary Glands ◽

Treatment Options ◽

Diagnosis And Treatment ◽

Salivary Duct ◽

Treatment Protocols ◽

Adequate Evaluation

Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.

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Investigating the Role of Everolimus in mTOR Inhibition and Autophagy Promotion as a Potential Host-Directed Therapeutic Target in Mycobacterium tuberculosis Infection

Journal of Clinical Medicine ◽

10.3390/jcm8020232 ◽

2019 ◽

Vol 8 (2) ◽

pp. 232 ◽

Cited By ~ 16

Author(s):

Stephen Cerni ◽

Dylan Shafer ◽

Kimberly To ◽

Vishwanath Venketaraman

Keyword(s):

Mycobacterium Tuberculosis ◽

Mammalian Target Of Rapamycin ◽

Treatment Protocol ◽

Current Treatment ◽

Current Therapy ◽

Mycobacterium Tuberculosis Infection ◽

Novel Therapy ◽

Mtor Inhibition ◽

Treatment Protocols ◽

Tb Treatment

Tuberculosis (TB) is a serious infectious disease caused by the pathogen Mycobacterium tuberculosis (Mtb). The current therapy consists of a combination of antibiotics over the course of four months. Current treatment protocols run into problems due to the growing antibiotic resistance of Mtb and poor compliance to the multi-drug-resistant TB treatment protocol. New treatments are being investigated that target host intracellular processes that could be effective in fighting Mtb infections. Autophagy is an intracellular process that is involved in eliminating cellular debris, as well as intracellular pathogens. Mammalian target of rapamycin (mTOR) is an enzyme involved in inhibiting this pathway. Modulation of mTOR and the autophagy cellular machinery are being investigated as potential therapeutic targets for novel Mtb treatments. In this review, we discuss the background of Mtb pathogenesis, including its interaction with the innate and adaptive immune systems, the mTOR and autophagy pathways, the interaction of Mtb with these pathways, and finally, the drug everolimus, which targets these pathways and is a potential novel therapy for TB treatment.

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2898. Achieving Hepatitis C SVR12 of 95% in Mono-Infected Patients with Severe Comorbidities Using Volunteer Staff and Minimal Clinic Visits and Phlebotomy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.176 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S82-S82

Author(s):

Charles M van der Horst ◽

Gary Greenberg ◽

Erin Kirchgessner ◽

Amanda Vaughn ◽

Edie Alfano-Sobsey ◽

...

Keyword(s):

Treatment Protocol ◽

The United States ◽

Hcv Treatment ◽

Treatment Protocols ◽

High Prevalence ◽

Pre Treatment ◽

Wake County ◽

Direct Acting ◽

Hcv Testing ◽

Clinic Visits

Abstract Background HCV is the most common chronic bloodborne infection in the United States with an estimated 3.5 million infected. With direct-acting antivirals, cure can be achieved in 8 to 12 weeks. To achieve WHO elimination targets by 2030 (>90% reduction in incidence) requires increased detection, access to care, and simpler treatment protocols that patients, challenged by substance use and mental health disorders, can readily complete. Methods In 2016, Wake County, NC began HCV testing at 32 sites finding prevalence >10% at 5 shelters and drug treatment centers. An adapted simplified HCV treatment protocol, used in the high prevalence settings of Ukraine and Burma, was implemented at the Open Door Clinic – a free clinic for uninsured persons living in poverty in Wake County. After initially using genotype-specific therapy, we switched to pan-genotypic sofosbuvir/velapatisvir (SOF/VEL) for 12 weeks. Clinic visits were limited to pre-treatment and 12 weeks after treatment completion. Patients were contacted weekly via text to check on their health and adherence. Results Thirty HCV mono-infected patients have initiated treatment including 9 women. 21 were infected by IDU, 5 by transfusion, 3 by sex with an infected partner, and 5 have unknown risk. In genotype (GT) testing 22 have GT1, 3 GT 2, and 4 GT3. Major comorbidities include 24 with current or recent IDU, alcohol dependency, psychotic depression or schizophrenia, or missing all medical appointments other than the HCV. Twenty-seven of 30 have completed their prescribed course of HCV therapy and 20 have achieved an SVR at 12 weeks. The 1 patient who failed was admitted to the hospital 4 times in the first 6 weeks of treatment and did not take his medication consistently. An additional 2 remain on treatment and 6 are awaiting results of testing done at 12 weeks post-therapy completion. One patient died within 2 weeks of initiating therapy due to a perforated duodenal ulcer. Conclusion Using targeted on-site HCV testing, we identified high prevalence sites. Implementing a simplified HCV treatment program reduces patient and clinic burden and resulted in 95% achieving SVR12 despite severe comorbidities. Expansion of this program to other clinics in Wake County is underway. Disclosures All Authors: No reported Disclosures.

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A randomised phase II study to evaluate the efficacy and safety of Chemotherapy (CT) vs Androgen Deprivation Therapy (ADT) in patients with recurrent and/or metastatic, Androgen Receptor (AR) expressing, Salivary Gland Cancer (SGC)

10.26226/morressier.596cd2b8d462b80292387c64 ◽

2017 ◽

Author(s):

Carmela Caballero

Keyword(s):

Salivary Gland ◽

Androgen Receptor ◽

Androgen Deprivation Therapy ◽

Phase Ii ◽

Phase Ii Study ◽

Androgen Deprivation ◽

Salivary Gland Cancer ◽

Efficacy And Safety

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Systemic Therapy for Salivary Gland Cancer

Salivary Gland Pathology ◽

10.1002/9781119730248.ch14 ◽

2021 ◽

pp. 455-469

Author(s):

Janakiraman Subramanian ◽

Lara Kujtan

Keyword(s):

Salivary Gland ◽

Systemic Therapy ◽

Salivary Gland Cancer

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Neurofibromin expression by normal salivary glands

Head & Face Medicine ◽

10.1186/s13005-021-00256-4 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Eloá Borges Luna ◽

Pâmella Pinho Montovani ◽

Rafaela Elvira Rozza-de-Menezes ◽

Karin Soares Cunha

Keyword(s):

Salivary Gland ◽

Salivary Glands ◽

Acinar Cells ◽

Staining Intensity ◽

Neurofibromatosis 1 ◽

Tissue Type ◽

Sublingual Gland ◽

Minor Salivary Glands ◽

Expression Levels ◽

Ductal Cells

AbstractIntroductionNeurofibromin, a protein encoded by theNF1gene, is mutated in neurofibromatosis 1, one of the most common genetic diseases. Oral manifestations are common and a high prevalence of hyposalivation was recently described in individuals with neurofibromatosis 1. Although neurofibromin is ubiquitously expressed, its expression levels vary depending on the tissue type and developmental stage of the organism. The role of neurofibromin in the development, morphology, and physiology of salivary glands is unknown and a detailed expression of neurofibromin in human normal salivary glands has never been investigated.AimTo investigate the expression levels and distribution of neurofibromin in acinar and ductal cells of major and minor salivary glands of adult individuals without NF1.Material and methodTen samples of morphologically normal major and minor salivary glands (three samples of each gland: parotid, submandibular and minor salivary; and one sample of sublingual gland) from individuals without neurofibromatosis 1 were selected to assess neurofibromin expression through immunohistochemistry. Immunoquantification was performed by a digital method.ResultsNeurofibromin was expressed in the cytoplasm of both serous and mucous acinar cells, as well as in ducts from all the samples of salivary glands. Staining intensity varied from mild to strong depending on the type of salivary gland and region (acini or ducts). Ducts had higher neurofibromin expression than acinar cells (p = 0.003). There was no statistical association between the expression of neurofibromin and the type of the salivary gland, considering acini (p = 0.09) or ducts (p = 0.50) of the four salivary glands (parotid, submandibular, minor salivary, and sublingual gland). Similar results were obtained comparing the acini (p = 0.35) and ducts (p = 0.50) of minor and major salivary glands. Besides, there was no correlation between the expression of neurofibromin and age (p = 0.08), and sex (p = 0.79) of the individuals, considering simultaneously the neurofibromin levels of acini and duct (n = 34).ConclusionNeurofibromin is expressed in the cytoplasm of serous and mucous acinar cells, and ductal cells of salivary glands, suggesting that this protein is important for salivary gland function.

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