Page 166 - New epidemiological and PSMA-expression based paradigms in salivary gland tumors
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Chapter 11
reproductive cancers (breast, ovarian, endometrium cancer) has received a lot of attention because of the role of these hormones in activating specific signaling pathways after binding to e.g. the estrogen receptor in these tissues [5,6]. However, other entities, like the salivary gland tumors that also have these receptors, seem to claim their small share of attention as has been shown by publications over the years [4,7,8]. And a relation of salivary gland tumors with other tumor types with hormone receptors might follow.
The fact that new medical techniques can not only shed a new light on the origin of diseases and diagnostical possibilities and therapy outcomes, but also on anatomical perspectives, was shown in the chapters of the second part of this thesis (Chapter 7, 8, 9 and 10)[9–12].
Shifting the focus of attention of a new diagnostic modality for prostate cancer, to the use for head and neck cancer lead to an array of surprising findings. Prostate specific membrane antigen (PSMA) positron emission tomography / computed tomography (PET/CT) for the first time showed PSMA-ligand binding to minor salivary and seromucous glands in Chapter 7. This offers possibilities for radiotherapy treatment planning aiming for sparing of these glands in order to preserve quality of life for patients. Loss of PSMA-ligand binding capacity after (partial) gland radiation could been seen on PSMA PET/CT scans in Chapter 8. Further research is expected to answer questions on how these scans can be used in radiotherapy for head and neck cancer patients. The finding of a large bilateral collection of gland tissue in the dorsolateral nasopharyngeal wall in Chapter 9 showed that new perspectives regarding the understanding of anatomy and possible clinical consequences are still possible. Although this perspective of a possible new “organ at risk” (which is a term in radiotherapy for organs and tissues at risk for radiation damage) was carefully reported with nuances regarding its interpretation, the popular media interpreted and reported it as a new organ (Figure 1). In Chapter 10 we therefore pointed out that we were standing on the shoulders of giants in anatomy in describing this new perspective regarding presence of nasopharyngeal glandular tissue. The PSMA PET/CT scan made it possible for the first time, to delineate and interpret these gland collections as macroscopic glands, which could be a potential new organ at risk in radiotherapy. In general, standing on shoulders is not enough to translate anatomical knowledge or new findings into clinical relevance. Researchers and clinicians need to connect






























































































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