Abstract: Objective：To investigate clinical features of distant metastases (DM)and analyze clinicopathologic risk factors associated with DM from salivary gland carcinomas after being treated by surgery combined with ¹²⁵I internal brachytherapy. Methods: Between October 2001 and March 2010, 197 patients with salivary gland carcinoma were treated by surgery combined with ¹²⁵I internal brachytherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate clinicopathologic risk factors that might influence the risk of distant metastases.Results:  DM occurred in 28 of 197 patients (14.2%). The commonest site of distant metastases overall was the lung 89.3% (25/28), followed by bones 17.9% (5/28) and liver (4/28). DM developed after an average interval of (44.2±45.8) months from the time of initial diagnosis, and the mean interval was 64 months. The average time to death after the diagnosis of DM was only (9.7±13.4) months, and the mean time was 12 months. The 3-year locoregional control rate and survival rate were 90.8%, and 87.8% respectively，and the 5-year ones  84.0% and 81.0%, respectively. Univariate analyses revealed that the risk of distant metastases was significantly influenced by locoregional tumor failure (F=26.997，P<0.01) and histologic differentiation (F=1.592，P<0.01). Multivariate analysis of freedom from distant metastases revealed that locoregional control (F=29.332，P<0.01) significantly influenced this end point. Conclusion: Salivary gland carcinoma could achieve high local control rate after being treated by surgery combined with 125I internal brachytherapy, and the average interval from diagnosis to DM was prolonged, DM was significantly influenced bylocoregional control.

Key words: Salivary gland neoplasms, Neoplasm metastasis, Brachytherapy, Iodine radioisotopes