Brachytherapy for recurrent malignant tumours of the parotid gland

To find out if brachytherapy with radioactive seeds was effective in patients with recurrent malignant tumours of the parotid gland we retrospectively studied 64 such patients, 24 of whom were treated with implantation of radioactive seeds alone, and 40 of whom had their recurrent tumours resected followed by implantation of radioactive seeds. Patients were followed up for a mean of 50 months (range 4 months to 12 years). The local control rate was 76.6%, and overall survival 79.7%. Of the 24 patients treated with brachytherapy alone, 22 achieved a complete response (91.7%). At 1, 3, and 5 years the local control rates were 81.5%, 67.2%, and 53.8%, respectively, and the overall survival 82.7%, 70%, and 61.2%, respectively. In the 40 patients whose tumours were resected before brachytherapy, the local control rates at 1, 3, and 5 years were 87.5%, 82.4%, and 78.6%, respectively, and the overall survival was 97.5%, 86.5%, and 86.5%, respectively. Sex, age, histopathological grade, size of tumour, history of radiotherapy, time of recurrence and method of treatment were not shown to have a significant effect on local control, but method of treatment had a significant impact on overall survival (p=0.008). We conclude that treatment of recurrent malignant tumours of the parotid efficacy can be successfully treated with brachytherapy with radioactive seeds, either alone or combined with resection.