Radiation Therapy With or Without Chemotherapy in Treating Patients With High-Risk Malignant Salivary Gland Tumors That Have Been Removed By Surgery

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Pathologically proven diagnosis of a malignant major salivary gland tumor or malignant minor salivary gland tumor of the head and neck of the following histologic subtypes:
• •* Intermediate-grade adenocarcinoma or intermediate-grade mucoepidermoid carcinoma
• •* High-grade acinic cell carcinoma or high-grade (\>30% solid component) adenoid cystic carcinoma
• •Surgical resection with curative intent within 8 weeks prior to registration
• •All patients must have a Medical Oncology evaluation within 4 weeks prior to registration
• •Pathologic stage T3-4 or N1-3 or T1-2, N0 with a close (≤ 1mm) or microscopically positive surgical margin; patients must be free of distant metastases based upon the following minimum diagnostic workup:
• •* History/physical examination within 8 weeks prior to registration
• •* Radiologic confirmation of the absence of hematogenous metastasis within 12 weeks prior to registration; at a minimum, contrast CT imaging of the chest is required (PET/CT is acceptable)
• •No patients with residual macroscopic disease after surgery
• •No prior systemic chemotherapy or radiation therapy for salivary gland malignancy
• •PATIENT CHARACTERISTICS:
• •Zubrod performance status 0-1
• •Absolute neutrophil count (ANC) ≥ 1,800 cells/mm\^3
• •Platelets ≥ 100,000 cells/mm\^3
• •Hemoglobin ≥ 8.0 g/dL (the use of transfusion or other intervention to achieve hemoglobin ≥ 8.0 g/dL is acceptable)
• •Serum creatinine \< 2.0 mg/dL
• •Total bilirubin \< 2 x the institutional upper limit of normal (ULN)
• •Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \< 3 x the institutional ULN
• •Negative serum pregnancy test within 2 weeks prior to registration for women of childbearing potential
• •Women of childbearing potential and male participants who are sexually active must practice adequate contraception during treatment and for 6 weeks following treatment
• •Not pregnant or nursing
• •Patients must be deemed able to comply with the treatment plan and follow-up schedule
• •Patients must provide study specific informed consent prior to study entry, including consent for mandatory tissue submission for central review
• •No prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible)
• •No severe, active co-morbidity, defined as follows:
• •* Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months
• •* Transmural myocardial infarction within the last 6 months
• •* Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
• •* Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
• •* Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects (coagulation parameters are not required for entry into this protocol)
• •* Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control (CDC) definition (HIV testing is not required for entry into this protocol)
• •* Protocol-specific requirements may also exclude immunocompromised patients
• •* Pre-existing ≥ grade 2 neuropathy
• •No significant pre-existing hearing loss, as defined by the patient or treating physician
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics
• •No prior systemic chemotherapy or radiation therapy for salivary gland malignancy (prior chemotherapy for a different cancer is allowable)
• •No prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
• •No prior organ transplant
• •No concurrent hematopoietic growth factors (e.g., G-CSF or pegfilgrastim) during radiotherapy
• •No concurrent erythropoiesis-stimulating agents