125Ⅰ seed brachytherapy for recurrent salivary gland carcinoma after external radiotherapy / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical application and efficacy of 125Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy.@*METHODS@#From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with 125Ⅰ radioactive seeds implantation only and 18 cases were treated with 125Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects.@*RESULTS@#The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%.@*CONCLUSION@#125Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.

Injúrias causadas às glândulas salivares pós-radioterapia

A radioterapia apresenta um importante papel no tratamento da maioria das pessoas com câncer de cabeça e pescoço. A despeito de todos os benefícios que a radioterapia traz, danos aos tecidos sadios, que circundam a região tumoral, são inevitáveis. As glândulas salivares, por estarem muitas vezes nos portais de radioação, são muito afetadas devido à radioterapia...

Management of salivary gland tumours: a 10 years institutional experience

A retrospective longitudinal study was conducted on 166 patients of clinically evident salivary gland tumours over a period of l0years with the main aim to assess the prognosis of the various surgical techniques used in the management of salivary gland tumours. All the patients underwent detailed clinical examination and FNAC. CECT and MR scan were done whenever indicated. After meticulous assessment of the extent and establishment of the cytopathological diagnosis, these cases underwent surgical excision of the tumour. Various surgical approaches were described for the excision of the tumours of various size, type and extension, with or without nodal metastasis. Neck dissection was done in 54% cases of salivary gland malignancies. Excisional biopsy was done in all of the cases. Post-operative radiotherapy was given in 26% cases. 6% cases of malignant salivary gland tumours showed recurrence

Carcinoma de ducto salivar: relato de caso e revisão de literatura / Salivary duct carcinoma: case report and review of literature

O carcinoma de ductos salivares (CDS) é uma neoplasia extremamente rara, sendo responsável por 0,5 por cento de todos os carcinomas de glândulas salivares. O objetivo do presente estudo é relatar o caso de um paciente com CDS e revisar a literatura pertinente. Paciente do sexo masculino, 81 anos, branco, procurou assistência médica com queixa de nódulo em região parotídea direita com 02 anos de crescimento insidioso. Foi realizada punção aspirativa por agulha fina (PAAF) do nódulo, sendo o diagnóstico citológico positivo para malignidade e condizente com carcinoma pouco diferenciado. Após foi submetido à parotidectomia com esvaziamento cervical à direita. O exame anatomopatológico da peça cirúrgica evidenciou CDS. O CDS atinge principalmente homens na sexta e sétima décadas de vida. O tratamento constitui de excisão do tumor associada a esvaziamento cervical radical, pela agressividade da doença. O papel da quimioterapia permanece obscuro dada a sua infreqüência, mas a radioterapia é indicada para diminuir as recidivas. A histologia desses tumores tem como principal característica a semelhança com o carcinoma ductal de mama.

Adenoma pleomórfico en glándulas salivales menores: reporte de tres casos en niños / Pleomorphic adenoma in minor salivary gland: report of three cases in children

Los tumores de las glándulas salivares son escasos durante la primera y segunda décadas de la vida y cuando ocurre en estos grupos de edades, se presentan generalmente en la glándula parótida. Los tumores en las glándulas salivares menores son todavía más escasos, siendo el adenoma pleomórfico el más común. La mayoría de los autores definen el adenoma pleomórfico como una tumoración submucosa oval o redondeada, única, bien delimitada, no infiltante, dura-elástica e indolora. La mucosa que lo cubre está intacta, sin embargo, puede ulcerarse secundariamente debido al crecimiento intrínseco del tumor o por trauma, su crecimiento es lento. Cuando el adenoma pleomórfico se presenta en el paladar se debe hacer diagnóstico diferencial con otras patologías como son las de tipo infeccioso, los quistes y los tumores odontogénicos y no odontogénicos y finalmente, las lesiones pseudotumorales. El tratamiento para el adenoma pleomórfico es la enucleación completa; la mayoría de los autores recomiendan la excisión local amplia extendiéndose al menos medio cm. por fuera del márgen visible del tumor. Puede ser necesaria la fenestración del paladar blando para obtener los márgenes quirúrgicos requeridos. En la literatura mundial solo se han reportado 8 casos de adenoma pleomórfico en el paladar en niños. Presentamos 3 casos de adenomas pleomórficos en glándulas salivares menores del paladar en pacientes de sexo masculino: uno en un niño de 8 años y dos casos en jóvenes de 15 años de edad.

Carcinoma epitelial-mioepitelial. Experiencia clínico-patológica de 6 casos / Epithelial-myepithelial carcinoma. Clinical and pathological features in six cases

El carcinoma epitelial mioepitelial, es una neoplasia poco común que afecta glándulas salivales, principalmente glándula parótida (75 porciento), cuya conducta biológica es considerada como de bajo potencial maligno. Histológicamente, caracterizada por doble patrón celular neoplásico: células epiteliales ductales y células mioepiteliales. Seis casos de carcinoma epitelial mioepitelial se estudiaron retrospectivamente, el 50 por ciento de estos se localizaron en glándula parótida, dos pacientes cursaron con recurrencia regional en ganglios cervicales, además uno de ellos con metástasis a distancia. Tres pacientes se encuentran vivos sin actividad tumoral (50 por ciento). Este estudio fue realizado para correlacionar los aspectos morfológicos con la evolución clínica de los pacientes

Diagnóstico e tratamento das neoplasias das glândulas salivares menores: estudo de 55 casos / Diagnosis and treatment of the tumors of the minor salivary glands: study of 55 cases

Os autores apresentam um estudo de 55 pacientes portadores de neoplasias das pequenas glândulas salivares da cabeça e pescoço. Houve idêntica incidência de lesöes benignas e malignas. A característica destas neoplasias é a pobreza de sintomas, sendo habitualmene o diagnóstico obtido através da biópsia excisional. O tratamento para estas neoplasias é o cirúrgico, sendo a radioterapia reservadao como associaçäo pós-operatória