[ Special series on 骨肉瘤 ]
doi: 10.1186/s40880-016-0153-8
Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma
Lie-Qiang Liao, Hong-Hong Yan, Jun-Hao Mai, Wei-Wei Liu, Hao Li, Zhu-Ming Guo, Zong-Yuan Zeng and Xue-Kui Liu
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
[Abstract]
Background The increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible (RIOSM) has become a significant problem that can limit long-term survival. The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC).
Methods We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded.
Results For all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty-nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who underwent resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1-, 2-, and 3-year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treatment type.
Conclusions RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.
Background The increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible (RIOSM) has become a significant problem that can limit long-term survival. The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC).
Methods We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded.
Results For all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty-nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who underwent resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1-, 2-, and 3-year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treatment type.
Conclusions RISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.
Chinese Journal of Cancer 2016, Volume: 35, Issue 11
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Lie-Qiang Liao, Hong-Hong Yan, Jun-Hao Mai, Wei-Wei Liu, Hao Li, Zhu-Ming Guo, Zong-Yuan Zeng and Xue-Kui Liu. Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma. Chin J Cancer. 2016, 35:89. doi:10.1186/s40880-016-0153-8
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[ Html full-text / Citation export] (BioMed Central)
[Google Scholar]
[ More articles of the special series on 骨肉瘤 ]
Cite this article
Lie-Qiang Liao, Hong-Hong Yan, Jun-Hao Mai, Wei-Wei Liu, Hao Li, Zhu-Ming Guo, Zong-Yuan Zeng and Xue-Kui Liu. Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma. Chin J Cancer. 2016, 35:89. doi:10.1186/s40880-016-0153-8
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