Nonsurgical management of human immunodeficiency virus‐associated parotid cysts: A systematic review and meta‐analysis

Background The purpose of this clinical review was to analyze the effectiveness of nonsurgical management options for human immunodeficiency virus (HIV)‐associated parotid cysts. Methods We conducted systematic and meta‐analysis reviews. Primary outcomes were complete or partial responses. Results Systematic review identified 12 relevant studies. The average rates of complete response for antiretroviral therapy (ART), sclerotherapy, and fine‐needle aspiration (FNA) were 52.8%, 55.5%, and 33.3%, respectively. Three radiotherapy studies, totaling 104 patients, were included in a meta‐analysis. Patients receiving high‐dose therapy achieved complete and partial response rates of 65.8% (95% confidence interval [CI] 54.3%‐76.2%) and 25.2% (95% CI 16.1%‐36.3%), respectively. Patients receiving low‐dose therapy achieved complete and partial response rates of 23.2% (95% CI 1.2%‐60.9%) and 22.3% (95% CI 5.2%‐87.8%), respectively. The rate of complete response was significantly greater for high‐dose radiotherapy compared to low‐dose (P < .001). Conclusion Among nonsurgical treatment modalities for HIV‐associated parotid cysts, radiotherapy has the highest number of reported outcomes in the literature and our analysis suggests that higher dose radiotherapy has higher rates of achieving complete response.