Postoperative [¹²⁵I] seed brachytherapy in the treatment of acinic cell carcinoma of the parotid gland: with associated risk factors.
BACKGROUND
This retrospective study was undertaken to analyze data from patients receiving iodine-125 ([(125)I]) seed brachytherapy postoperatively for the treatment of acinic cell carcinoma (ACC) of the parotid gland along with the following risk factors: residual tumor, recurrent tumor, facial nerve invasion, positive resection margins, advanced tumor stage, or tumor spillage.


METHODS
Twenty-nine patients with ACC (17 females, 12 males; age range, 13-73 years; median age, 37.3 years) were included. Median follow-up was 58.2 months (range, 14-122 months). Patients received [(125)I] seed brachytherapy (median actuarial D90, 177 Gy) 3-41 days (median, 14 days) following surgery. Radioactivity was 18.5-33.3 MBq per seed, and the prescription dose was 80-120 Gy.


RESULTS
The 3-, 5-, and 10-year rates of local control were 93.1, 88.7, and 88.7 %, respectively; overall survival was 96.6, 92, and 92 %; disease-free survival was 93.1, 88.4, and 88.4 %; and freedom from distant metastasis was 96.6, 91.2, and 91.2 %. Lymph node metastases were absent in all patients, although two patients died with distant metastases. Facial nerve recovery was quick, and no severe radiotherapy-related complications were noted. Recurrence history, local recurrence, and distant metastasis significantly affected overall survival.


CONCLUSIONS
Postoperative [(125)I] seed brachytherapy is effective in treating ACC and has minor complications. Patients with a history of recurrence showed poor prognosis and were more likely to experience disease recurrence and develop metastases.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 100081, Beijing, P.R.China.
Ming-Hui
MH
Mao
Jian-Guo
JG
Zhang
Jie
J
Zhang
Lei
L
Zheng
Shu-Ming
SM
Liu
Ming-Wei
MW
Huang
Yan
Y
Shi
D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D018267:Carcinoma, Acinar Cell / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D010307:Parotid Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011182:Postoperative Care / Q000379:methods; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals