Radiation-induced second primary squamous cell carcinoma of the oral cavity after radiotherapy for nasopharyngeal carcinoma
Radiation-induced second primary squamous cell carcinoma of the oral cavity after radiotherapy for nasopharyngeal carcinoma
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DOI：
10.1016/j.oraloncology.2020.104863
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发表时间：
2020-10-01
期刊：
影响因子：
4.8
通讯作者：
Liu, Xuekui
中科院分区：
文献类型：
--
作者：
Liu, Chao;Liao, Lieqiang;Liu, Xuekui
背景：鼻咽癌（NPC）放疗后放射诱发的第二原发性口腔鳞状细胞癌（RISCCO）的发生率不断增加，已成为影响长期生存的值得注意的并发症。本研究旨在分析鼻咽癌放疗后发生RISCCO的患者的临床病理特征与预后因素的关系。方法：回顾性分析1989年8月至2019年1月中山大学肿瘤防治中心（SYSUCC）收治的41,446例鼻咽癌患者。在这些患者中，符合纳入标准的 88 例 RISCCO 患者被纳入研究。结果：在我们的研究期间，SYSUCC 鼻咽癌患者放疗后 RISCCO 的发生率为 0.21% (88/41,446)。潜伏期为 1.0 至 34.0 年（中位数为 9.0 年），接受调强放射治疗的患者的 RISCCO 潜伏期明显短于接受钴 60 或 6-MV X 射线常规放疗的患者（中位数为 4.0 年 vs. 11.0 年，P = 0.013）。整个队列的 88 名患者的 1 年、3 年和 5 年总生存 (OS) 率分别为 79.0%、46.6% 和 35.2%。接受治疗的79名患者的5年OS率为45.7%，拒绝治疗的9名患者的5年OS率为0%。 T分型和手术被确定为与高OS率相关的独立预后因素。结论：手术作为首选治疗可以改善生存和预后。需要长期随访以早期发现鼻咽癌患者的 RISCCO。
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.