How would you approach patients with high risk mucoepidermoid carcinoma (high grade) of the parotid gland for optimal adjuvant treatment?

Would be nice to know all the risk factors - margins, PNI, etc.

Due to high-risk features, adjuvant RT is appropriate and guideline-concordant

However, there is no strong supporting evidence to add adjuvant chemo as salivary gland cancers are typically not chemo-sensitive.

Published real-world data suc...

The question of adjuvant therapy for this high-grade mucoepidermoid cancer is reasonable but I am in agreement with others that RT alone is the appropriate and evidence-based management in this case. Guidance from published literature consists mainly of retrospective case series that are heterogeneo...

Postop RT. 60 Gy/30 fractions for R0, 66/33 for R1, 70/35 for R2 margins

I agree. Data does not yet support radio sensitization for salivary gland tumors.

RT alone