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Radiation-induced sarcoma in patients with nasopharyngeal carcinoma
A single-institution study
Article first published online: 16 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 23, pages 5479–5486, 1 December 2010
How to Cite
Xi, M., Liu, M.-Z., Wang, H.-X., Cai, L., Zhang, L., Xie, C.-F. and Li, Q.-Q. (2010), Radiation-induced sarcoma in patients with nasopharyngeal carcinoma. Cancer, 116: 5479–5486. doi: 10.1002/cncr.25329
- Issue published online: 23 NOV 2010
- Article first published online: 16 AUG 2010
- Manuscript Accepted: 17 FEB 2010
- Manuscript Revised: 1 JAN 2010
- Manuscript Received: 2 SEP 2009
- radiation-induced sarcoma;
- nasopharyngeal carcinoma;
- radiation therapy;
- second primary malignancy;
- treatment modality
The increasing incidence of radiation-induced sarcoma (RIS) has become a significant problem that can limit long-term survival. The objective of the current study was to analyze the clinicopathologic characteristics, treatment outcomes, and prognostic factors of RIS after radiotherapy for nasopharyngeal carcinoma (NPC).
Institutional electronic medical records of patients with NPC who received definitive radiotherapy between February 1964 and 2003 were reviewed. Fifty-three patients who developed RIS and fulfilled the study criteria were included.
The median follow-up after a diagnosis of RIS was 15.5 months (range, 0.4-90.3 months), and the median latency between radiotherapy for NPC and an RIS diagnosis was 9.3 years (range, 3.2-26.6 years). Fibrosarcoma was the most frequent histologic type observed, followed by osteosarcoma, and malignant fibrous histiocytoma. The 3-year overall survival (OS) rate for 49 patients who received treatment was 32.4%, and the median survival was 21.2 months (95% confidence interval, 8.7-33.8 months). The median OS was 41.3 months, 8.4 months, and 11 months for the complete resection group, the incomplete resection group, and the chemotherapy group, respectively (P<.0001). The only independent predictive factor that was associated with better OS was complete surgical resection.
This retrospective study confirmed the rarity and poor prognosis of RIS in patients with NPC. Complete surgical resection was a significant prognostic factor for survival. The authors concluded that long-term follow-up is necessary for the early detection of RIS in patients with NPC. Cancer 2010. © 2010 American Cancer Society.