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

Abstract

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. 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. 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. 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.