Surgery combined with postoperative 125 I seed brachytherapy for the treatment of mucoepidermoid carcinoma of the parotid gland in pediatric patients

Pediatr Blood Cancer. 2017 Jan;64(1):57-63. doi: 10.1002/pbc.26217. Epub 2016 Aug 31.

Abstract

Background: This retrospective study was undertaken to analyze the effectiveness and safety of surgery combined with postoperative 125 I seed brachytherapy in the treatment of mucoepidermoid carcinoma (MEC) of the parotid gland with risk factors in pediatric patients.

Procedure: From September 2002 to January 2012, 24 patients, ages 5-16 years (mean, 13.2 years; median, 12.3 years), with MEC of the parotid gland were included. Patients with high risk factors received 125 I seed brachytherapy (median actuarial D90, 97 Gy) within 4 weeks following surgery. Radioactivity was 18.5-33.3 MBq per seed and the prescription dose was 60-120 Gy. Overall and disease-free survival rates, local control rate, and distant metastasis were recorded. Radiation-associated late side effects, including dermatitis, hearing loss, thyroid nodules, and secondary malignancy, were also evaluated.

Results: During the follow-up period of 5-13.4 years (median, 7.2 years), the overall and disease-free survival rates were all 100%. No patients developed local recurrence, regional/distant metastasis, and no severe radiation-associated complications including the second malignancy were noted.

Conclusion: Surgery combined with postoperative 125 I seed brachytherapy is effective and safe in the treatment of MEC of the parotid gland in pediatric patients, with no evidence of severe late radiation-related complications. More patients and longer follow-up data are still needed to prove the efficacy of 125 I brachytherapy.

Keywords: 125I seed brachytherapy; mucoepidermoid carcinoma; parotid gland; pediatric.

MeSH terms

  • Adolescent
  • Brachytherapy*
  • Carcinoma, Mucoepidermoid / pathology
  • Carcinoma, Mucoepidermoid / therapy*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Male
  • Neoplasm Staging
  • Parotid Neoplasms / pathology
  • Parotid Neoplasms / therapy*
  • Postoperative Care*
  • Prognosis
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Rate

Substances

  • Iodine Radioisotopes