2ND HEAD AND NECK CANCERS FOLLOWING RADIATION-THERAPY OF T1 AND T2 CANCERS OF THE ORAL CAVITY AND OROPHARYNX
2ND HEAD AND NECK CANCERS FOLLOWING RADIATION-THERAPY OF T1 AND T2 CANCERS OF THE ORAL CAVITY AND OROPHARYNX
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DOI：
10.1016/0360-3016(92)91022-f
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发表时间：
1992-01-01
影响因子：
7
通讯作者：
LEBOURGEOIS, JP
中科院分区：
文献类型：
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作者：
FIJUTH, J;MAZERON, JJ;LEBOURGEOIS, JP
在1970年1月至1987年3月期间，在Henri Mondor医院接受T1和T2口腔和口咽癌治疗的600名患者中，评估了头颈区放射治疗后发生第二癌的风险。75例（12.5%）患者仅接受外照射治疗，243例（40.5%）患者接受放射治疗和铱192治疗，282例（47%）患者单独接受铱192治疗。115名患者（19%）在首次治疗后3至183个月（中位：32个月）发生第二肿瘤，其中69名患者（11.5%）在头颈部被诊断为第二恶性肿瘤。发现发生第二头颈癌的精算风险增加且持续（2.7%/年观察）。单因素分析显示，年龄、性别、分期和初始治疗方式对第二次头颈癌的发生风险没有影响；软腭癌患者发生第二次头颈部恶性肿瘤的风险较高（p < 0.05）。多变量分析显示，唯一一组更容易发生第二头颈癌的患者是仅接受铱192照射的患者（p = 0.0076）。软腭癌患者发生第二次头颈部恶性肿瘤的风险更大（p = 0.059）。67%的患者通过手术和/或再照射对第二次头颈部恶性肿瘤进行根治性治疗。最初仅接受铱192治疗的患者比先前接受外束放疗的患者更容易接受挽救性治疗（79% vs 53%, p = 0.02）。第二次头颈癌诊断后的2年和5年总体生存率分别为32%和10%。
The risk of second cancer in the head and neck region following definitive radiation therapy was evaluated among 600 patients who were treated for T1 and T2 cancers of the oral cavity and oropharynx at the Henri Mondor hospital between January 1970 and March 1987. Seventy-five patients (12.5%) were managed with external irradiation only, 243 (40.5%) with RT and Iridium 192, and 282 (47%) with Iridium 192 alone. One hundred fifteen patients (19%) developed a second cancer from 3 to 183 months after initial therapy (median: 32 months), including 69 patients (11.5%) in whom the second malignancy was diagnosed in the head and neck region. An increased and constant actuarial risk of development of second head and neck cancer was found (2.7%/year of observation). Univariate analysis showed that age, sex, stage, and modality of the initial treatment did not influence the risk of second head and neck cancer; there was a greater risk of second head and neck malignancy for those patients with soft palate carcinoma (p < 0.05). Multivariate analysis revealed that the only group of patients who developed a second head and neck cancer more frequently were those who were irradiated with Iridium 192 only (p = 0.0076). There was a trend toward a greater risk of second head and neck malignancy for those with soft palate carcinoma (p = 0.059). Radical treatment of the second head and neck malignancy by surgery and/or re-irradiation was performed for 67% of patients. Patients initially treated by Iridium 192 only could undergo salvage treatment more often than those who previously received external beam radiotherapy (79% vs 53%, p = 0.02). The overall 2-year and 5-year survivals after the diagnosis of the second head and neck cancer were 32% and 10%, respectively.