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Drug therapy of salivary gland cancer

Salivary gland cancer is rare and is a histologically diverse disease. The WHO classification contains 24 different subgroups.

Due to the rarity of the disease, there are few studies on chemotherapy for salivary gland cancer, and the high number of subgroups complicates results. There is not much to suggest that treatment with chemotherapy prolongs survival, therefore the goal is to palliate symptoms.

Drug therapy should be reserved for patients with symptoms and/or rapid disease progression. In patients with an indolent disease course, progression should be observed to determine the rate. This is important for evaluation of response to later treatment.

There is little indicating that multiple regimens are better than single regimens. Of single regimens effective for adenoid cystic carcinoma are mitoxanthrone, vinorelbine, and epirubicine. Of multiple regimens, an effective combination is cisplatin-doxorubicin-cyclophosphamide (CAP), with or without fluorouracil. It is important to be aware of the danger of increased toxicity with multiple drug regimens. Paclitaxel appears to be inactive for adenoid cystic carcinoma, but may have slight activity on mucoepidermoide carcinomas. Paclitaxel, vinorelbine, and CAP have shown effect on adenocarcinomas.

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