Clinical results of definitive radiotherapy for local recurrent kimura disease in the head and neck after surgery: A retrospective study

Abstract

Objective: To evaluate the efficacy and safety of definitive radiotherapy in selected patients with local recurrence of Kimura disease of the head and neck after surgery.

Methods: This retrospective study collected the clinical data of 14 patients with postoperative recurrence of Kimura disease of the head and neck who received definitive radiotherapy at the First AffiliatedHospital of Fujian Medical University between 2006 and 2022. The radiation dose ranged from 28 to 40 Gy. Its efficacy and safety were analyzed.

Results: During follow-up, ranging from 17 to 168 months, local control was achieved in 13 (92.9%) of the 14 patients with postoperative recurrence. There were no serious late toxicities except for mild xerostomia in four (28.6%) patients; the patients’ peripheral blood eosinophil count dropped from 1.73×10⁹/L before treatment to 0.42×10⁹/L after treatment, and the eosinophil percentage dropped from 20.64% to 9.78%. Both changes were statistically significant (p<0.001).

Conclusions: The findings of the study suggest that definitive radiotherapy is a viable and effective alternative to repeated surgery for managing recurrent Kimura disease of the head and neck, with significant response rates and a good safety profile. Peripheral blood eosinophil counts and percentages serve as simple and reliable biomarkers for monitoring Kimura disease progression and treatment responses.

Keywords

Kimura disease / radiotherapy / head and neck / tumor recurrence

References

[1] Kim WJ, Kim HK. Current concepts of Kimura disease: pathophysiology and evolution of treatment. Arch Craniofac Surg. 2022;23(6):249-255.

[2] Kim HT, Szeto C. Eosinophilic hyperplastic lymphogranuloma, comparison with mikulicz’s disease. Chin Med J. 1937;23(5):699-700.

[3] Kimura T, Yoshimura S, Ishikawa E. On the unusual granulation combined with hyperplastic changes of lymphatic tissues. Trans Soc Pathol Jpn. 1948;37:179–180.

[4] Yang B, Liao H, Wang M, et al. Kimura’s disease successively affecting multiple body parts: a case-based literature review. BMC Ophthalmol. 2022;22(1):154.

[5] Lee CC, Feng IJ, Chen YT, et al. Treatment algorithm for Kimura’s disease: A systematic review and meta-analysis of treatment modalities and prognostic predictors. Int J Surg. 2022;100:106591.

[6] Ye P, Ma DQ, Yu GY, Gao Y, Peng X. Comparison of the efficacy of different treatment modalities for Kimura’s disease. Int J Oral Maxillofac Surg. 2017;46(3):350-354.

[7] Fionda B, Loperfido A, Bussu F, et al. The role of radiotherapy in Kimura’s disease: amulticenter systematic review of literature. Eur Rev Med Pharmacol Sci. 2021;25(12):4205-4210.

[8] Chang AR, Kim K, Kim HJ, Kim IH, Park CI, Jun YK. Outcomes of Kimura’s disease after radiotherapy or nonradiotherapeutic treatment modalities. Int J Radiat Oncol Biol Phys. 2006;65(4):1233-1239.

[9] Sun GC, Liu F, Sun Y, et al. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018;32(10):782-786.

[10] Takeishi M, Makino Y, Nishioka H, Miyawaki T, Kurihara K. Kimura disease: diagnostic imaging findings and surgical treatment. J Craniofac Surg. 2007;18(5):1062-1067.

[11] Muangwong P, Chitapanarux I, Ya-In C, Klibngern H, Kongmebhol P. Natural history and treatment outcome of radiotherapy for Kimura’s disease. Indian J Cancer. Published online August 7, 2021.

[12] Hareyama M, Oouchi A, Nagakura H, et al. Radiotherapy for Kimura’s disease: the optimum dosage. Int J Radiat Oncol Biol Phys. 1998;40(3):647-651.

RIGHTS & PERMISSIONS

2024 The Author(s). Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.