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European Archives of Oto-Rhino-Laryngology

Published in:

01-10-2016 | Head and Neck

Management algorithm for HIV-associated parotid lymphoepithelial cysts

Authors: Waleed F. Mourad, Shyamal Patel, Rebekah Young, Azita S. Khorsandi, Catherine Concert, Rania A. Shourbaji, Katherine Ciarrocca, Richard L. Bakst, Daniel Shasha, Chandan Guha, Madhur K. Garg, Kenneth S. Hu, Shalom Kalnicki, Louis B. Harrison

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2016

Abstract

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.

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Title: Management algorithm for HIV-associated parotid lymphoepithelial cysts
Authors: Waleed F. Mourad
Shyamal Patel
Rebekah Young
Azita S. Khorsandi
Catherine Concert
Rania A. Shourbaji
Katherine Ciarrocca
Richard L. Bakst
Daniel Shasha
Chandan Guha
Madhur K. Garg
Kenneth S. Hu
Shalom Kalnicki
Louis B. Harrison
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 10/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-3926-4

At a glance: The STEP trials

Springer Medicine

Management algorithm for HIV-associated parotid lymphoepithelial cysts

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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