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Radiation Therapy for Salivary Gland Cancer

Radiation therapy for salivary gland tumors involves sending high-energy particles (usually photons or protons) through the skin toward the tumor. When the particles reach the tumor, they can destroy cancer cells by damaging their DNA. Radiation therapy is known to be particularly effective against head and neck tumors, including salivary gland tumors.

Radiation therapy can be used in one of several ways for salivary gland cancers. It may be recommended after surgery to prevent the tumor from growing back. Radiation may also be used as the sole treatment if the tumor cannot be removed by surgery or if the tumor grows back after surgery.

Memorial Sloan Kettering’s Radiation Therapy Expertise

  • Our radiation therapy team has special training in caring for people with salivary gland cancer and benign salivary gland tumors. They work closely with the other members of your care team.
  • We have access to every form of state-of-the-art radiotherapy technology available.
  • MSK offers weekly MRI imaging at no cost to patients. This weekly mapping allows your radiation oncologist to optimize your radiation plan in real time.
  • You may be eligible to participate in clinical trials exploring new ways to boost the effectiveness of your treatment.

Types of Radiation Therapy for Salivary Gland Tumors

MSK’s team of radiation experts has access to every modern form of radiation therapy available. We will customize a treatment plan for you that is so precise that it factors in the size and shape of your tumor to the millimeter. Your team’s goal is two-fold: to eliminate tumor cells and to prevent the side effects of treatment by keeping the healthy cells around the tumor safe.

Learn more about the different technologies used in radiation therapy for salivary gland tumors.

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Intensity-modulated radiation therapy (IMRT) combines the use of a highly advanced computer program with a metal device called a collimator. Together, those tools allow your care team to shape the radiation beams to the exact size of the tumor or, if you’ve already had surgery, the area where the tumor was removed.

Prior to the start of radiation therapy, a team of experts will come together. That includes radiation oncologists and experienced medical physicists. They will collect detailed information about the treatment area, using the following:

  • a CT scan to map the tumor in 3-D
  • PET, CT, and MRI scans to generate an outline of the tumor

The team uses this information along with sophisticated treatment-planning software to calculate the best number of radiation beams and the exact angles of those beams. During treatment, the collimator is adjusted to produce beams at the angles specified by the computer program.

This approach allows us to deliver more-precise doses of radiation to the tumor while reducing the risk that healthy tissue is exposed. IMRT was developed by radiation therapy experts at Memorial Sloan Kettering.

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Image-guided radiation therapy (IGRT) uses imaging tests (CT, MRI, or PET) and special computer software to optimize the real-time delivery of radiation to the tumor or, if you’ve already had surgery, the area where the tumor was removed.

In this approach, daily imaging scans are performed to ensure that you are in the best position when the radiation is delivered. The imaging scans are processed by special software to map changes in the tumor’s size or location. Your radiation therapy team can use this information to improve the accuracy of the radiation treatments while you are receiving them.

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In conventional radiation treatment planning, a team of radiation oncologists, radiation therapists, medical physicists, and dosimetrists works together to formulate your plan of care. Your team then carries out that plan during your course of treatment, which typically lasts six to seven weeks. Adaptive radiotherapy simply means that we repeat the planning process throughout treatment. Every time we detect certain changes, such as weight loss or tumor shrinkage, that could affect the precision of the radiation, we review the plan.

This personalized approach allows us to continually optimize your care while sparing healthy tissue. It is particularly beneficial for people who did not have surgery to remove the tumor.

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Brachytherapy involves the placement of radioactive material in the body. The material is sealed inside a seed, pellet, wire, or capsule using a needle or catheter. The radiation given off by this source damages the DNA of nearby cancer cells. Brachytherapy is most commonly used for salivary gland cancer that has come back after prior treatment. Your doctors will discuss with you whether you are a candidate for brachytherapy.

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Proton therapy is delivered by a device called a cyclotron. It sends a high-energy beam of protons through the skin toward the tumor. Unlike photons, proton beams do not penetrate beyond the tumor. That’s why proton therapy reduces the likelihood of side effects caused by damage to normal tissues. It is also why proton therapy may allow the use of a higher radiation dose to the tumor, maximizing the chance of destroying it.

Proton therapy is extremely helpful for many people. At present, protons are most commonly used for salivary gland cancer that has come back after being treated.

Memorial Sloan Kettering is one of a limited number of centers nationwide that offers proton therapy.

Chemoradiation

Occasionally, your doctor will recommend chemotherapy as part of your care plan to increase the sensitivity of your tumor to radiation treatment. The combination of radiation plus chemotherapy is called chemoradiation.

Our researchers are studying drug therapies that may be used in combination with radiation to further reduce the risk of your cancer returning.

Clinical Trials

Clinical trials are research studies that test new treatments to see how well they work. People who choose to participate in a trial at MSK receive the most-advanced cancer treatment available, sometimes years before it’s offered anywhere else.

Our researchers are studying new ways to enhance your treatment for salivary gland cancer, including various approaches to radiation.

Learn more about clinical trials for salivary gland cancer.

Side Effects of Radiation Therapy

MSK’s radiation oncologists work hard to minimize the side effects of treatment. They will explain to you in detail what to expect and when side effects are likely to appear.

The most common side effects of radiation to the salivary glands include changes in your skin that look like a sunburn, hoarseness, changes in taste, dryness, weakening of the teeth, and pain, sores, or redness in the mouth.

Our rehabilitation experts have extensive experience in helping people address the side effects of radiation therapy. A speech and swallowing specialist will see you prior to treatment to teach you about the effects of radiation on your speech, voice, and swallowing function. The specialist will provide you with exercises to prevent changes as much as possible during treatment and for the long term.

The therapist will follow you throughout treatment and recovery. At every step, a plan for rehabilitation will be outlined.

Our dental oncology team is also available to support you with any problems that may arise with your teeth. They may fit you with a custom mouth guard to protect your teeth during treatment.

Our dietitians develop customized nutrition plans to help manage challenges with eating and drinking.