Chao Liu1, Lieqiang Liao2, Guoying Wu3, Honghong Yan4, Xiaoqi Chen4, Chao Wang4, Xiajing Zheng4, Ziyi Zeng5, Zheng Zhao4, Di Wu4, Xuekui Liu6. 1. School of Stomatology, Jilin University, Changchun 130041, Jilin, PR China. 2. Department of Otolaryngology Head and Neck Surgery, The First People's Hospital of Foshan, Foshan, Guangdong, PR China. 3. Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, PR China. 4. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China. 5. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China. 6. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, PR China. Electronic address: liuxk@sysucc.org.cn.
Abstract
BACKGROUND: The increasing occurrence of radiation-induced second primary squamous cell carcinoma of the oral cavity (RISCCO) after radiotherapy for nasopharyngeal carcinoma (NPC) has become a noteworthy complication that can influence long-term survival. This study aimed to analyze the associations of clinicopathologic characteristics with prognostic factors among patients who developed RISCCO after radiotherapy for NPC. METHODS: A total of 41,446 NPC patients admitted to Sun Yat-sen University Cancer Center (SYSUCC) between August 1989 and January 2019 were reviewed. Among these patients, 88 RISCCO patients who satisfied the inclusion criteria were included in the study. RESULTS: During our study, the incidence of RISCCO after radiotherapy was 0.21% (88/41,446) among NPC patients at SYSUCC. The latency period ranged from 1.0 to 34.0 years (median, 9.0 years), and the latency of RISCCO was notably shorter for patients who received intensity-modulated radiation therapy than that for patients who received conventional radiotherapy using cobalt-60 or 6-MV X-rays (median, 4.0 years vs. 11.0 years, P = 0.013). The 1-, 3-, and 5-year overall survival (OS) rates for the entire cohort of 88 patients were 79.0%, 46.6%, and 35.2%, respectively. The 5-year OS rate for the 79 patients who received treatment was 45.7%, and the 5-year OS rate for the 9 patients who refused treatment was 0%. T classification and surgery were identified as independent prognostic factors associated with a high OS rate. CONCLUSIONS: Surgery as the first-choice treatment may improve survival and prognosis. A long-term follow-up is needed for early detection of RISCCO in NPC patients.
BACKGROUND: The increasing occurrence of radiation-induced second primary squamous cell carcinoma of the oral cavity (RISCCO) after radiotherapy for nasopharyngeal carcinoma (NPC) has become a noteworthy complication that can influence long-term survival. This study aimed to analyze the associations of clinicopathologic characteristics with prognostic factors among patients who developed RISCCO after radiotherapy for NPC. METHODS: A total of 41,446 NPC patients admitted to Sun Yat-sen University Cancer Center (SYSUCC) between August 1989 and January 2019 were reviewed. Among these patients, 88 RISCCOpatients who satisfied the inclusion criteria were included in the study. RESULTS: During our study, the incidence of RISCCO after radiotherapy was 0.21% (88/41,446) among NPC patients at SYSUCC. The latency period ranged from 1.0 to 34.0 years (median, 9.0 years), and the latency of RISCCO was notably shorter for patients who received intensity-modulated radiation therapy than that for patients who received conventional radiotherapy using cobalt-60 or 6-MV X-rays (median, 4.0 years vs. 11.0 years, P = 0.013). The 1-, 3-, and 5-year overall survival (OS) rates for the entire cohort of 88 patients were 79.0%, 46.6%, and 35.2%, respectively. The 5-year OS rate for the 79 patients who received treatment was 45.7%, and the 5-year OS rate for the 9 patients who refused treatment was 0%. T classification and surgery were identified as independent prognostic factors associated with a high OS rate. CONCLUSIONS: Surgery as the first-choice treatment may improve survival and prognosis. A long-term follow-up is needed for early detection of RISCCO in NPC patients.
Authors: Carrie M Carr; John C Benson; David R DeLone; Felix E Diehn; Dong K Kim; Daniel Ma; Alex A Nagelschneider; Ajay A Madhavan; Derek R Johnson Journal: Neuroradiol J Date: 2022-05-01