title: The role of radiation therapy in pediatric mucoepidermoid carcinomas of the salivary glands.
abstract: OBJECTIVE
  To investigate the role of radiation therapy in rare salivary gland pediatric mucoepidermoid carcinoma (MEC).
  
  
  METHODS
  A French multicenter retrospective study (level of evidence 4) of children/adolescents treated for MEC between 1980 and 2010 was conducted.
  
  
  RESULTS
  Median age of the 38 patients was 14 years. Parotid subsite, low-grade, and early primary stage tumors were encountered in 81%, 82%, and 68% of cases, respectively. All except 1 patient were treated by tumoral surgical excision, and 53% by neck dissection (80% of high grades). Postoperative radiation therapy and chemotherapy were performed in 29% and 11% of cases. With a median 62-month follow-up, overall survival and local control rates were 95% and 84%, respectively. There was 1 nodal relapse. Lower grade and early stage tumors had better survival. Postoperative radiation therapy and chemotherapy were associated with similar local rates. Patients with or without prior cancer had similar outcomes.
  
  
  CONCLUSIONS
  Pediatric salivary gland MEC carries a good prognosis. Low-intermediate grade, early-stage tumors should be treated with surgery alone. Neck dissection should be performed in high-grade tumors. Radiation therapy should be proposed for high grade and/or advanced primary stage MEC. For high-grade tumors without massive neck involvement, irradiation volumes may be limited to the primary area, given the risk of long-term side effects of radiation therapy in children. Pediatric MEC as second cancers retain a similar prognosis. Long-term follow-up is needed to assess late side effects and second cancers.
authors.affiliation: Department of Radiation Oncology, Cancer Center Antoine-Lacassagne, Institut Universitaire de la Face et du Cou, University Nice Sophia-Antipolis, Nice, France. jthariat@hotmail.com
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Vedrine
authors.forename: Stephane
authors.initials: S
authors.lastname: Temam
authors.forename: Ali Mohamed
authors.initials: AM
authors.lastname: Ali
authors.forename: Daniel
authors.initials: D
authors.lastname: Orbach
authors.forename: Guillaume
authors.initials: G
authors.lastname: Odin
authors.forename: Marc
authors.initials: M
authors.lastname: Makeieff
authors.forename: Richard
authors.initials: R
authors.lastname: Nicollas
authors.forename: Martin
authors.initials: M
authors.lastname: Penicaud
authors.forename: Bruno
authors.initials: B
authors.lastname: Toussaint
authors.forename: Sebastien
authors.initials: S
authors.lastname: Vergez
authors.forename: Anne
authors.initials: A
authors.lastname: Laprie
authors.forename: Michel
authors.initials: M
authors.lastname: Rives
authors.forename: Karine
authors.initials: K
authors.lastname: Montagne
authors.forename: Natacha
authors.initials: N
authors.lastname: Teissier
authors.forename: Laurent
authors.initials: L
authors.lastname: Castillo
mesh_terms: D000293:Adolescent; D018277:Carcinoma, Mucoepidermoid / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010372:Pediatrics / Q000379:methods; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods