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The efficacy of iodine-125 interstitial brachytherapy for the treatment of locally advanced adenoid cystic carcinoma of the base of tongue: a non-surgical approach. J Contemp Brachytherapy 2021; 13:395-401. [PMID: 34484353 PMCID: PMC8407254 DOI: 10.5114/jcb.2021.108593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/06/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose The present study retrospectively evaluated the effectiveness and safety of iodine-125 interstitial brachytherapy for treatment of primary locally advanced adenoid cystic carcinoma (ACC) of the base of tongue (BOT). Material and methods This study was a retrospective analysis of data of 19 patients with ACC, who were treated with iodine-125 interstitial brachytherapy between March 2008 and April 2018. Overall survival (OS), disease-free survival (DFS), local control (LC), and radiation-related toxicities were determined. Factors affecting the outcomes were evaluated. Results Six males and 13 females were included in our study, with a median follow-up time of 35 months. 3- and 5-year OS rates were 71.5% and 47.6%, respectively. 3- and 5-year LC rates were 88.5% and 34.5%, respectively. 3- and 5-year DFS rates were 54.7% and 21.9%, respectively. A significant difference was observed in patients with or without brain metastases for OS rate. No severe acute toxicity was observed, while severe late toxicity was observed in one patient. Conclusions The results suggest that iodine-125 interstitial brachytherapy is an effective and safe option for the treatment of primary locally advanced ACC of the base of the tongue, with reasonably satisfactory LC and OS.
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Bravo Thompson H, Lim Law M, Vergara Vasquez R, Castillo Fernandez O. Parotid Myoepithelial Carcinoma in a Pediatric Patient with Multiple Recurrences: Case Report. Case Rep Oncol 2021; 14:989-997. [PMID: 34326733 PMCID: PMC8299374 DOI: 10.1159/000515783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/19/2022] Open
Abstract
Myoepithelial carcinoma of the salivary glands is a rare entity, with scarce amount of case reports in the literature. Due to its infrequency, its diagnosis is usually difficult and uncertain. Although there are reports of locoregional recurrences and distant metastases, its low incidence and varied biological behavior limits the clinical evidence that can be used to predict the prognosis and determine the course of treatment. We present a 23-year-old female patient without past medical history with an initial 1-year history of volume increase in the right parotid region of tumor aspect and painful on palpation. As a malignancy was suspected, a total parotidectomy was performed, reporting in the deep lobe a parotid myoepithelial carcinoma with vascular and neural invasion, negative borders, and 3–9 negative regional nodes. During her 16-year clinical evolution, she presented approximately every 2 years and a total of 9 locoregional recurrences and hepatic metastases, including cervical lymphoid nodules, temporal bone, frontal bone, and temporal fossa. Those recurrences have been treated with coordinated efforts between repeated external radiotherapy, chemotherapy, and multiple surgical resections. Myoepithelial tumors represent only 1.0–1.5% of all salivary gland tumors. The literature reports suggest a high incidence of locoregional recurrences and distant metastases in de novo myoepithelial carcinomas. Due to its rarity, treatment continues to be based on the experience of medical staff.
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Affiliation(s)
| | - Maria Lim Law
- Clinical Oncology, National Cancer Institute, Panama City, Panama
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Ma YQ, Zheng L, Huang MW, Liu SM, Lv XM, Zhang JG. Surgery combined with 125I brachytherapy for treatment of carcinoma ex pleomorphic adenoma of the parotid gland. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:395-404. [PMID: 33610540 DOI: 10.1016/j.oooo.2020.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/29/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effectiveness and safety of surgery combined with 125I seed brachytherapy for treatment of carcinoma ex pleomorphic adenoma (CXPA) of the parotid gland and to identify the factors associated with prognosis. STUDY DESIGN We conducted a retrospective analysis of data of patients with CXPA of the parotid gland treated with surgery plus 125I seed brachytherapy at the Peking University School of Stomatology Hospital between December 2003 and July 2018. RESULTS Fifty-five patients (median age, 51 years) were included in the study. Median follow-up was 50.5 months. The 3-, 5-, and 10-year overall survival rates were 91.1%, 91.1%, and 81.5%, respectively. The 3-, 5-, and 10-year local control rates were all 85.2%. Grades 1-3 adverse effects occurred in 22 patients; no grade 4 reactions occurred. T stage, N stage, tumor invasiveness, perineural invasion, and surgical margins significantly affected local control rates. Lymph node metastasis and perineural invasion were independent predictors of poor local control. Lymph node metastasis was an independent predictor of poor survival. CONCLUSIONS Surgery plus 125I seed brachytherapy appears to be an effective and safe treatment for CXPA of the parotid gland. T stage, N stage, tumor invasiveness, and perineural invasion are factors influencing prognosis.
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Affiliation(s)
- Yan-Qi Ma
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Lei Zheng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Ming-Wei Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Shu-Ming Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Xiao-Ming Lv
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology
| | - Jian-Guo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology.
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Li C, Liu SM, Zheng L, Huang MW, Shi Y, Lv XM, Zhang JG, Peng X, Zhang J. Comparison of outcomes using radiotherapy or brachytherapy after resection of primary adenoid cystic carcinoma in oral and maxillofacial regions. Brachytherapy 2020; 20:171-177. [PMID: 33069597 DOI: 10.1016/j.brachy.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/23/2020] [Accepted: 08/19/2020] [Indexed: 11/29/2022]
Abstract
We wished to investigate the outcome of surgery combined with external-beam radiotherapy (EBRT) or brachytherapy (125I seeds) for the treatment of primary adenoid cystic carcinoma (ACC) of the oral and maxillofacial region. Data of patients with primary ACC were reviewed retrospectively. Patients were divided into EBRT and brachytherapy groups. Wide tumor excision was done to achieve negative margins. Standard radiotherapy in the EBRT group was 60 Gy. A treatment-planning system was used to create implantation plans with a prescribed dose of 60-120 Gy and 125I seeds were implanted postoperatively. Kaplan-Meier method and log-rank tests were used to analyze local control and survival. The median duration of followup was 66.1 and 46.8 months for the EBRT group and brachytherapy group, respectively. There was no significant difference in local control, control of metastasis to regional lymph nodes, or control of distant metastasis between the two groups. There was no significant difference in overall survival, disease-specific survival, or disease-free survival in the two groups at 3 years and 5 years. The prevalence of complications in the brachytherapy group was lower than that in the EBRT group. Both methods elicited good treatment effects, but the prevalence of adverse events was lower in the brachytherapy group.
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Affiliation(s)
- C Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - S M Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - L Zheng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - M W Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Y Shi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - X M Lv
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - J G Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - X Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - J Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Liu J, Wu T, Man Q, Fidèle NB, Zheng Y, Liu B. Three-Dimensional Printed Plate-Guided 125I Brachytherapy for Malignant Parotid Tumors. J Oral Maxillofac Surg 2018; 76:2113-2121. [DOI: 10.1016/j.joms.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 11/28/2022]
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Liu JY, Man QW, Ma YQ, Liu B. I 125 brachytherapy guided by individual three-dimensional printed plates for recurrent ameloblastoma of the skull base. Br J Oral Maxillofac Surg 2017; 55:e38-e40. [PMID: 28669443 DOI: 10.1016/j.bjoms.2017.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 05/24/2017] [Indexed: 12/24/2022]
Abstract
Ameloblastoma is one of the most common benign odontogenic tumours of the mandible and the maxilla. Wide excision of the tumour is the first choice for treatment (except for unicystic ones). Patients with invaded margins or unresectable lesions may require radiotherapy. Today, permanent implantation of I125 seeds is widely used in the treatment of cancer of the head and neck. We report a case of recurrent ameloblastoma of the base of the skull that was treated with I125 brachytherapy. The outcome has been encouraging, with total disappearance of the tumour on positron emission tomography 18 months later.
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Affiliation(s)
- J-Y Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Q-W Man
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Y-Q Ma
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - B Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
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Wakasaki T, Kubota M, Nakashima Y, Tomonobe E, Mihara T, Fukushima J. Invasive myoepithelial carcinoma ex pleomorphic adenoma of the major salivary gland: two case reports. BMC Cancer 2016; 16:827. [PMID: 27793123 PMCID: PMC5084397 DOI: 10.1186/s12885-016-2871-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/21/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Myoepithelial carcinoma (MEC) is a rare salivary gland tumor. Its long-term prognosis remains unknown because of the paucity of reported cases with long-term follow-up. Although some case series exist, the clinical features of MEC vary considerably depending on the site of origin. Therefore, accumulation of these rare cases is important. CASE PRESENTATION Case 1: An 89-year-old man presented with a 10-year history of a mass originating from the right parotid gland and involving the neck. The mass grew rapidly for 3 months, reaching approximately 8 cm. There was no facial paralysis. MEC ex pleomorphic adenoma (PA) was suspected. Superficial parotid gland resection was performed in 2013; the tumor grade was pT3N0M0, and the resection margins were free of carcinoma. Because of several high-risk factors for metastasis (i.e., invasive carcinoma ex PA, high MIB1 index, and mutant p53 protein positivity), radiotherapy and chemotherapy were recommended as adjuvant therapy. Although the patient refused adjuvant therapy, he was recurrence-free at 36 months after surgery. Case 2: A 54-year-old woman presented with a >10-year history of a right submandibular mass, which grew rapidly for 1 year, reaching approximately 6 cm. Preoperative diagnosis was PA of the right submandibular gland. Submandibular gland resection was performed in 2013. Pathological analysis revealed invasive MEC ex PA, pT3N0M0; in addition, the carcinoma portion had an extra capsule and had invaded the platysma muscle close to the margin. An MIB1 index of 40 % and mutant p53 protein positivity indicated a high risk for metastasis. Additional resection and right neck dissection revealed no residual carcinoma. The patient refused adjuvant chemotherapy. One year after surgery, metastasis to the right pulmonary hilar node and both lungs were detected. Chemotherapy prevented recurrent growth of the lesion and extended survival. The patient was alive with cancer 30 months after the first surgery. CONCLUSIONS High expression of the Ki67 labeling index might reflect prognosis of these cases. Chemotherapy for distant metastasis was effective, as expected. Further accumulation of cases and long follow-up data are needed to elucidate the pathophysiology and prognosis of MEC ex PA.
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Affiliation(s)
- Takahiro Wakasaki
- Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Miniami-ku, Fukuoka, 815-8555, Japan. .,Department of Head and Neck Surgery, National Hospital Organization, Kyushu Cancer Center, 3-1-1 Notame, Miniami-ku, Fukuoka, 811-1395, Japan.
| | - Marie Kubota
- Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Miniami-ku, Fukuoka, 815-8555, Japan
| | - Yutaka Nakashima
- Department of Pathology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Miniami-ku, Fukuoka, 815-8555, Japan
| | - Eri Tomonobe
- Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Miniami-ku, Fukuoka, 815-8555, Japan
| | - Takenao Mihara
- Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Miniami-ku, Fukuoka, 815-8555, Japan
| | - Junichi Fukushima
- Department of Otorhinolaryngology, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Miniami-ku, Fukuoka, 815-8555, Japan
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