Acinic cell carcinoma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Ramyar Ghandriz MD[2]

## Overview

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Low grade, low stage (I and II) and adequately resected acinic cell carcinoma are not considered for any further therapy, as their prognosis is excellent with surgery alone. Criteria for additional radiotherapy of acinic cell carcinoma does not differ with other salivary gland carcinomas. There is insufficient information regarding chemotherapy in acinic cell carcinoma. Observation of distant metastasis with a rate of 1 in 5 indicate the need for developing such regimen.

## Medical Therapy

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* Low grade, low stage (I and II) and adequately resected acinic cell carcinoma are not considered for any further therapy, as their prognosis is excellent with surgery alone. additional medical therapies are:[1]

### Radiotherapy

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Criteria for additional radiotherapy of acinic cell carcinoma does not differ with other salivary gland carcinomas and include:[2]

* Salvage surgery for recurrent disease
* Advanced T-classification(T3/T4)
* Positive surgical lymph margins
* Pathologically positive cervical lymph node
* Perineural invasion
* High grade/Highly proliferative tumors.

Conversely Biron et al suggest that 'radiotherapy probably is not effective in acinic cell carcinoma.[3]

### Chemotherapy

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* There is insufficient information regarding chemotherapy in acinic cell carcinoma.[4]
* Some have suggested of positive effects of mTOR inhibitors due to acinic cell carcinoma, but no specific chemotherapy regimen have been currently approved.
* Observation of distant metastasis with a rate of 1 in 5 indicate the need for developing such regimen.

## References

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1. ↑ Vander Poorten, Vincent L. M.; Marchal, Francis; Nuyts, Sandra; Clement, Paul M. J. (2010). "Parotid carcinoma: Current diagnostic workup and treatment". Indian Journal of Surgical Oncology. 1 (2): 96–111. doi:10.1007/s13193-010-0022-x. ISSN 0975-7651.
2. ↑ Patel, Neal R.; Sanghvi, Saurin; Khan, Mohemmed N.; Husain, Qasim; Baredes, Soly; Eloy, Jean Anderson (2013). "Demographic trends and disease‐specific survival in salivary acinic cell carcinoma: An analysis of 1129 cases". The Laryngoscope. 124 (1): 172–178. doi:10.1002/lary.24231. ISSN 0023-852X.
3. ↑ Biron, Vincent L.; Lentsch, Eric J.; Gerry, Daniel R.; Bewley, Arnaud F. (2015). "Factors influencing survival in acinic cell carcinoma: A retrospective survival analysis of 2061 patients". Head & Neck. 37 (6): 870–877. doi:10.1002/hed.23686. ISSN 1043-3074.
4. ↑ Vander Poorten, V.; Triantafyllou, A.; Thompson, L. D. R.; Bishop, J.; Hauben, E.; Hunt, J.; Skalova, A.; Stenman, G.; Takes, R. P.; Gnepp, D. R.; Hellquist, H.; Wenig, B.; Bell, D.; Rinaldo, A.; Ferlito, A. (2015). "Salivary acinic cell carcinoma: reappraisal and update". European Archives of Oto-Rhino-Laryngology. 273 (11): 3511–3531. doi:10.1007/s00405-015-3855-7. ISSN 0937-4477.

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