Management of recurrent alveolar soft-part sarcoma of the tongue after external beam radiotherapy with iodine-125 seed brachytherapy

Head Neck. 2014 Dec;36(12):E125-8. doi: 10.1002/hed.23648. Epub 2014 Apr 9.

Abstract

Background: Alveolar soft part sarcoma (ASPS) is a rare type of soft tissue sarcoma. The infrequency of ASPS is such that it accounts for <1% of all soft tissue sarcomas and <0.1% of sarcomas concerning the head and neck, primarily those involving the orbit (48%) and tongue (25%). Traditional chemotherapy or radiotherapy of ASPS is often associated with poor outcome, even after comprehensive interventions.

Methods and results: We performed iodine-125 ((125) I) seed brachytherapy under ultrasound guidance through a submandibular puncture in a 4-year-old boy with recurrent ASPS of the tongue. The prescription dose was 120 Gy; therefore, 35 (125) I seeds were implanted with 0.77 mCi per seed, the total amount of activity being 26.95 mCi. CT scans confirmed a complete response after the treatment.

Conclusion: Our patient now has a recurrent-free survival of >30 months, an amount of time longer than the median rate described in the literature.

Keywords: 125I seed; alveolar soft-part sarcoma; brachytherapy; outcome; ultrasound guidance.

Publication types

  • Case Reports

MeSH terms

  • Brachytherapy*
  • Child, Preschool
  • Humans
  • Iodine Radioisotopes / administration & dosage*
  • Male
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / radiotherapy*
  • Sarcoma, Alveolar Soft Part / diagnosis
  • Sarcoma, Alveolar Soft Part / radiotherapy*
  • Tongue Neoplasms / diagnosis
  • Tongue Neoplasms / radiotherapy*

Substances

  • Iodine Radioisotopes