1048P - Radiation-induced malignancy following definitive radiotherapy for nasopharyngeal carcinoma

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Complications of Treatment
Head and Neck Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Mian Xi
Authors M. Xi, L. Zhang, M. Liu, Q. Li
  • Department Of Radiation Oncology, Cancer Center, Sun Yat-sen University, 510060 - Guangzhou/CN

Abstract

Purpose

To analyze the clinicopathological characteristics, treatment modalities, and potential prognostic factors of radiation-induced malignancy (RIM) in patients with nasopharyngeal carcinoma (NPC).

Methods

We reviewed institutional electronic medical records of 39,118 patients with NPC treated by definitive radiotherapy between February 1964 and 2003. A total of 228 patients with confirmed RIM were included in this study.

Results

The median latency between radiotherapy for NPC and the diagnosis of RIM was 9.5 years (range, 3.1 to 30.2 years). Squamous cell carcinoma was the most common histologic type, followed by fibrosarcoma, osteosarcoma, and adenocarcinoma. Median progression-free survival and overall survival (OS) of the 216 patients who underwent treatment were 18.7 months (95% CI, 12.8 to 24.5) and 32.0 months (95% CI, 23.8 to 40.1), respectively. Five-year OS rates were 36.9% and 20.2% for carcinoma and sarcoma, respectively (P = 0.004). The 5-year OS rates were 45.4%, 21.8%, and 0% for the surgery (140 patients), radiotherapy (44 patients), and chemotherapy (32 patients) groups, respectively (P = 0.000). The independent prognostic factors associated with improved OS were histologic diagnosis of carcinoma and complete surgical resection.

Conclusion

Histologic type and treatment modality were the significant prognostic factors for patients with RIM. Complete resection apparently offers the best chance for long-term survival. In select patients with locally advanced and unresectable RIM, reirradiation should be strongly considered as a curative option.

Disclosure

All authors have declared no conflicts of interest.