Radiation-Induced Osteosarcomas of the Calvarium and Skull Base
Radiation-Induced Osteosarcomas of the Calvarium and Skull Base
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DOI：
10.1002/cncr.25734
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发表时间：
2011-05-15
期刊：
影响因子：
6.2
通讯作者：
DeMonte, Franco
中科院分区：
文献类型：
--
作者：
Patel, Akash J.;Rao, Vikas Y.;DeMonte, Franco
背景技术背景：虽然是电离辐射的罕见并发症，但随着放射治疗的普及和癌症生存率的提高，放射诱导的骨肉瘤现在更经常被认识到。到目前为止，关于放射诱发的颅骨骨肉瘤的出版物仅限于少数小系列和病例报告。方法：数据来自德克萨斯大学M。D.回顾安德森癌症中心1975年至2007年的放射性骨肉瘤患者。诊断标准为：1）骨肉瘤出现在先前的照射区域内; 2）新肉瘤在组织学上不同于原始肿瘤; 3）在照射时没有新肉瘤的证据; 4）可以识别明显的潜伏期。频率和描述性统计，获得了研究中的各种特征。结果：作者确定了16例放射诱导的颅骨骨肉瘤患者。诊断时的平均年龄为35岁。中位潜伏期为12.5年。颅底肿瘤9例，颅骨肿瘤7例。手术治疗的14例患者中，86%发生局部复发。中位生存时间为29个月，5年生存率为29.6%。结论：作者报道了最大系列的颅骨放射性骨肉瘤。虽然放射线诱发的骨肉瘤是放射线治疗的罕见但可怕的并发症，但随着放射线治疗频率和癌症存活率的增加，其发病率在未来可能会增加。这些肿瘤具有局部侵袭性，尽管进行了积极的手术和药物治疗，但其局部复发率和死亡率很高。Cancer 2011; 117：2120-6. (C)2010美国癌症协会
BACKGROUND: Although a rare complication of ionizing radiation, radiation-induced osteosarcoma is now more frequently recognized as radiation therapy has become common and cancer survival has increased. To date, publications on radiation-induced osteosarcoma of the cranium are limited to a few small series and case reports. METHODS: Data from 175 patients with a history of sarcoma of the head at The University of Texas M. D. Anderson Cancer Center from 1975 to 2007 were reviewed to identify patients with radiation-induced osteosarcoma. The diagnostic criteria were: 1) osteosarcoma arose within the previously irradiated field; 2) new sarcoma was histologically distinct from the original neoplasm; 3) no evidence of new sarcoma at the time of radiation; and 4) distinct latency period could be recognized. Frequencies and descriptive statistics were obtained for the various characteristics under study. RESULTS: The authors identified 16 patients with radiation-induced osteosarcoma of the cranium at their institution. The average age at diagnosis was 35 years. The median latency period was 12.5 years. Nine patients had skull base tumors, and 7 had calvarial tumors. Of the 14 patients treated surgically, 86% developed local recurrence. The median survival time was 29 months, and the 5-year survival rate was 29.6%. CONCLUSIONS: The authors report the largest series of cranial radiation-induced osteosarcoma. Although radiation-induced osteosarcoma is an uncommon but dire complication of radiotherapy, its incidence will probably increase in the future as the frequency of radiation treatment and cancer survival increase. These tumors are locally aggressive, and despite aggressive surgical and medical management, they have a high rate of local recurrence and mortality. Cancer 2011; 117: 2120-6. (C) 2010 American Cancer Society.