Efficacy of surgery combined with postoperative 125 I interstitial brachytherapy for treatment of acinic cell carcinoma of the parotid gland in children and adolescents.
Pediatr Blood Cancer
; 67(7): e28343, 2020 07.
Article
in En
| MEDLINE
| ID: mdl-32391970
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 125 I 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 125 I 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 125 I 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 125 I 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 125 I IBT.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Postoperative Care
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Surgical Procedures, Operative
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Brachytherapy
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Parotid Neoplasms
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Carcinoma, Acinar Cell
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Iodine Radioisotopes
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Neoplasm Recurrence, Local
Type of study:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Language:
En
Journal:
Pediatr Blood Cancer
Journal subject:
HEMATOLOGIA
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NEOPLASIAS
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PEDIATRIA
Year:
2020
Type:
Article