Three-Dimensional Printed Plate-Guided 125I Brachytherapy for Malignant Parotid Tumors

J Oral Maxillofac Surg. 2018 Oct;76(10):2113-2121. doi: 10.1016/j.joms.2018.05.001. Epub 2018 May 10.

Abstract

Purpose: The treatment of malignant parotid tumors with 125I brachytherapy is rarely reported. This study evaluated the efficacy and dose and response of 125I brachytherapy in patients with malignant tumors.

Materials and methods: From July 2014 through August 2017, 39 patients with malignant parotid tumors were treated with 125I brachytherapy. Thirty-five patients were treated with conservative surgical resection before brachytherapy. Four patients were treated with brachytherapy alone. Clinical outcomes and side effects were evaluated. Clinical factors were investigated to determine correlations with local control (LC) and side effects.

Results: Mean follow-up was 25 months (range, 7 to 47 months). The LC rate was 87.2% and the overall survival rate was 97.4%. High tumor grade and large tumor showed a propensity for local recurrence. Acute skin toxicity occurred in 87.2% of patients and grade 3 and 4 radioepidermitis was found in 20.5% of patients. In total, 89.7% of patients with facial nerve dysfunction recovered within 12 months.

Conclusions: 125I brachytherapy was a feasible treatment option for patients with malignant parotid tumors. Although side effects were minimal, strict follow-up was necessary for patients treated with a high dose.

MeSH terms

  • Adult
  • Aged
  • Brachytherapy / methods*
  • Combined Modality Therapy
  • Facial Nerve / physiopathology
  • Facial Nerve / radiation effects
  • Female
  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Male
  • Middle Aged
  • Neck Dissection / methods
  • Parotid Neoplasms / diagnostic imaging*
  • Parotid Neoplasms / radiotherapy*
  • Parotid Neoplasms / surgery
  • Printing, Three-Dimensional*
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Image-Guided / methods*
  • Retrospective Studies
  • Survival Rate
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome

Substances

  • Iodine Radioisotopes
  • Iodine-125