Benign parotid hypertrophy in plus HIV patients: Limited late failures after external radiation

Purpose: Although 8-10 Gy of external radiation therapy for +HIV associated parotid hypertrophy has achieved high response rates, the responses were t ransient with only 1/12 of patients retaining cosmetic control at median fo llow-up procedures of 9.5 months. Retreatment for failures after 8-10 Gy ha s also been unsatisfactory. Having shown that 24 Gy of external radiation t herapy for benign parotid hypertrophy produced more durable cosmetic contro l than 8-10 Gy, we now report on longer follow-up periods on a group of pat ients receiving 24 Gy. Materials and Methods: Twenty +HIV patients with clinical and radiographic evidence of lymphoepithelial lesions of the parotid were treated with 24 Gy of external radiation therapy using daily 1.5 Gy fractions; parallel oppos ed technique and 6 MV photons were used in 19 patients, and unilateral elec tron treatment was performed for one patient. Results: With a mean follow-up period of 24 months, the cosmetic control ap pears durable. We have had no late failures past 24 months. Two patients ha ve complained of modest xerostomia. There was no correlation with size of t he cyst and eventual cosmetic result. Conclusions: Twenty-four Gy produces durable parotid control for HIV associ ated lymphoepithelial lesions of the parotid glands in +HIV patients. Failu res after 2 years are uncommon and the side effects have been tolerable. (C ) 1999 Elsevier Science Inc.