LOW-DOSE RADIOTHERAPY FOR MULTICYSTIC BENIGN LYMPHOEPITHELIAL LESIONSOF THE PAROTID-GLAND IN HIV-POSITIVE PATIENTS - LONG-TERM RESULTS

Background. Multicystic benign lymphoepithelial lesions of the parotid gland (BLL) seen in patients with human immunodeficiency virus (HIV) can produce considerable cosmetic deformity as well as physical discom fort. We previously reported our preliminary results with low-dose rad iotherapy in this disease, and all 8 patients were satisfied with the initial improvement in their appearance. We now report the long-term f ollow-up of those patients and additional patients. Methods. Twelve HI V-positive patients with BLL were treated with 8-10 Gy of external rad iation using 2-Gy daily fractions. Objective responses and subjective duration of patient-defined cosmetic control were recorded. Results. A ll 12 patients (100%) had at least a 50% decrease in the size of their parotid masses. Five of 12 (42%) had a complete response and 7 (58%) had a partial response. Persisting complete response was achieved in o nly 1 patient, however, with relapse in the other 11 patients. Cosmeti c palliation, as judged by the patients, was achieved for a median of 9.5 months. Eight patients were subsequently retreated with doses of 6 -16 Gy (median and mode: 10 Gy). None (0%) of the 8 patients retreated achieved local control. Conclusions. Very low-dose radiation (8-10 Gy ) provides reliable but temporary cosmetic palliation for BLL. Retreat ment was unsatisfactory, and we are now investigating higher initial d oses of radiation to prolong palliation and eliminate recurrences. (C) 1995 John Wiley & Sons, Inc.