Efficacy of surgery combined with postoperative 125I interstitial brachytherapy for treatment of acinic cell carcinoma of the parotid gland in children and adolescents
- 1 July 2020
- journal article
- research article
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 67 (7), e28343
- https://doi.org/10.1002/pbc.28343
Abstract
Background Acinic cell carcinoma (AciCC) is rare in children; therefore, reaching a consensus on its management is challenging and radiotherapy is limited by concerns about long-term toxicity. The purpose of this study is to analyze the effectiveness and safety of surgery plus postoperative I-125 interstitial brachytherapy (IBT) for children and adolescents with AciCC of the parotid gland (PG) treated at a single institution. Procedure Sixteen patients <= 18 years old with AciCC of the PG treated with surgery plus I-125 IBT from 2007 to 2018 were included. Surgery was the primary treatment; ten patients underwent total gross excision and six subtotal gross excision. The matched peripheral dose was 60-120 Gy. Overall survival, disease-free survival (DFS), local control rate, distant metastasis, and radiation-associated toxicities were analyzed, and factors influencing outcomes were evaluated. Results During follow-up (1.8-12.6 years; mean, 6.3 years), lymph node metastasis was observed in one case, 2.6 years after I-125 IBT treatment. The five-year overall and DFS rates were 100% and 91.7%, respectively. On univariate analysis, tumor size >= 3 cm (100% vs 50%; P = 0.025) and extraglandular extension (100% vs 50%; P = 0.025) were significant prognostic indicators for DFS. No severe radiation-associated complications occurred. Conclusions Children and adolescents with AciCC of the PG with high-risk features can be managed using surgery plus postoperative I-125 IBT with excellent local control. Radiation-related complications were minor. Patients with facial nerve involvement can have their facial nerves preserved. Residual tumors can be safely managed using adjuvant I-125 IBT.Keywords
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