Postirradiation sarcoma of the head and neck

Abstract

Background. With improvement in survival after cancer treatment, it is becoming increasingly important to study treatment‐related morbidity and mortality. Sarcoma can develop in the irradiated field after radiation therapy. The authors performed a study to estimate the risk, and compared the risk of sarcoma after radiation therapy with that of other treatment modalities used against cancer. Methods. Between 1955 and 1988, 229 patients with sarcoma of the head and neck were seen at the University of California, Los Angeles (UCLA), Medical Center. Of these, 13 (6%) had a previous history of radiation therapy to the head and neck. Results. Radiation doses were known in 10 of 13 patients and ranged from 30 to 124.4 Gy. The latency time from radiation therapy to the development of postirradiation sarcoma (PIS) ranged from 3 months to 50 years, with a median of 12 years. More than 2000 patients have received radiation therapy to the head and neck for various conditions at the UCLA Medical Center since 1955. Conclusions. The authors conclude that most head and neck sarcomas are not radiation related and that the risk of PIS after head and neck irradiation for other diseases is low. From a review of the literature comparing mortality risks of chemotherapy, general surgery, and anesthesia, the risk of PIS appears no worse. Given the large number of patients who can be cured or receive palliation with radiation therapy, concern about PIS should not be a major factor influencing treatment decisions in patients with cancer.

MRI of radiation-induced tumors of the head and neck in post-radiation nasopharyngeal carcinoma

“…Patients undergoing a full course of RT for NPC received a dose equivalent to about 66 Gy or more, and most sarcomas in this series arose in the maxillary region, the middle and posterior part of which received this full radiation dose. The development of sarcomas after radiation exposure for both benign and malignant conditions is well established in the head and neck with a reported latency period from a few months to 65 years [19,20]. For those arising after treatment for NPC, the reported range is 6-27 years with a mean of 13 years [8], although in this series they arose after 4-18 years.…”

Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

“…The 3-year OS rate for patients with RIS in our series (32.4%) was within the lower end of the wide range reported previously (8%-60% at 5 years). [3][4][5][6][7][8][9][10][11][12][13]34 The best survival outcome was reported by Tabone et al, 35 who reported that the OS and eventfree survival rates for 23 patients with radiation-related osteosarcoma at 8 years were 50% and 41%, respectively.…”

“…Mark et al reported the poor survival of patients with RIS, including a 5-year OS rate of 8% for those with sarcomas in the head and neck. 34 In addition, the survival rates for patients with RIS in the head and neck was poor relative to the rates for patients with de novo sarcomas in head and neck. In a study by Patel et al, 10 the 5-year diseasefree survival rate in the RIS group was significantly worse than that in the de novo group (31% vs 54%).…”

Hearing Loss Revealing a Squamous Cell Carcinoma of External Auditory Canal in a Post-Irradiated Patient for Nasopharyngeal Carcinoma

“…The post-irradiated EAC carcinoma has been infrequently reported [18][19][20][21][22][23][24][25]. Lo et al [5] reported that the incidence of EAC carcinoma in the post-irradiated NPC population was 1000 times greater than the reported incidence of primary EAC carcinoma in the general population.…”