Page 149 - New epidemiological and PSMA-expression based paradigms in salivary gland tumors

The tubarial glands paper: A starting point. A reply to comments
There are more clinical concerns than only in radiotherapy
We thank Thakar et al. for their contribution regarding the clinical implications of the findings reported in our paper [18]. The realization of the presence of these relatively large glandular structures might indeed have clinical consequences in more (aspects of) diseases than we described in our paper. They report diagnostic concerns in juvenile nasal angiofibroma (JNA) evaluated by PSMA PET/CT. Also, pathological concerns are mentioned in diagnosing tumors in the nasopharynx that should take the tubarial glands into account. But perhaps most importantly regarding our paper, they emphasize the relevance for head and neck radiotherapy and suggest routinely implementation as an organ at risk. The authors of the original paper made recommendations regarding implementation: “We prefer to acquire external validation in an independent dataset and advise to change clinical protocols only in the setting of continued monitoring of anticipated clinical benefits”. For this reason, we referred to our original paper as “a starting point” in the title of this reply to the comments in 8 letters-to-the-editor.
Acknowledgements
The authors thank Dr. J.W. Bok of the Flevohospital, Almere (NL) for providing the clinical images.
Appendix A Supplementary data
Supplementary data to this article are available online at https://doi.org/10.1016/j. radonc.2020.12.001
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