Published in:
01-10-2014 | Original article
Postoperative [125I] seed brachytherapy in the treatment of acinic cell carcinoma of the parotid gland
With associated risk factors
Published in: Strahlentherapie und Onkologie | Issue 11/2014
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Background
This retrospective study was undertaken to analyze data from patients receiving iodine-125 ([125I]) 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.
Patients and 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 [125I] 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.
Conclusion
Postoperative [125I] 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.