Radiation‐Induced Malignancy of the Head and Neck

Sale, Keith A.; Wallace, Derrick I.; Girod, Douglas A.; Tsue, Terance T.

doi:10.1016/j.otohns.2004.05.012

Cited by 65 publications

(48 citation statements)

References 9 publications

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“…Since then, there have been several reports of patients developing radiation-induced sarcomas with shorter latency periods (as short as 2 years). 2,9,20 The shortest latency period in our group was 4.5 years. Laskin et al 21 reported a link between shorter latency periods and worse outcomes with radiation-induced soft-tissue sarcomas, but this relationship has not been further substantiated in the literature.…”

Section: Discussionmentioning

confidence: 46%

Radiation‐induced osteosarcomas of the calvarium and skull base

Patel

Rao

Fox

et al. 2010

Cancer

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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.

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Section: Discussionmentioning

confidence: 46%

Radiation‐induced osteosarcomas of the calvarium and skull base

Patel

Rao

Fox

et al. 2010

Cancer

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“…[18][19][20][21]29 In our study, we used the most common latency criteria of 3 to 4 years as reported by Arlen et al 21 The median latency in our series, 9.3 years, was consistent with data from other studies, in which the median latency ranges from 7.6 years to 22 years. [3][4][5][6][7][8][9][10][11]29 The shorter period of 7.6 years reported by Kuttesch et al 26 may be explained by the younger age of their patients. In addition, the administration of chemotherapy may shorten the interval between RT for the first cancer and the subsequent presentation of RIS.…”

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

“…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.…”

Section: Radiation-induced Sarcoma In Npc/xi Et Almentioning

confidence: 99%

Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

Liu

Wang

et al. 2010

Cancer

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BACKGROUND:The increasing incidence of radiation-induced sarcoma (RIS) has become a significant problem that can limit long-term survival. The objective of the current study was to analyze the clinicopathologic characteristics, treatment outcomes, and prognostic factors of RIS after radiotherapy for nasopharyngeal carcinoma (NPC). METH-ODS: Institutional electronic medical records of patients with NPC who received definitive radiotherapy between February 1964 and 2003 were reviewed. Fifty-three patients who developed RIS and fulfilled the study criteria were included. RESULTS: The median follow-up after a diagnosis of RIS was 15.5 months (range, 0.4-90.3 months), and the median latency between radiotherapy for NPC and an RIS diagnosis was 9.3 years (range, 3.2-26.6 years). Fibrosarcoma was the most frequent histologic type observed, followed by osteosarcoma, and malignant fibrous histiocytoma. The 3-year overall survival (OS) rate for 49 patients who received treatment was 32.4%, and the median survival was 21.2 months (95% confidence interval, 8.7-33.8 months). The median OS was 41.3 months, 8.4 months, and 11 months for the complete resection group, the incomplete resection group, and the chemotherapy group, respectively (P<.0001). The only independent predictive factor that was associated with better OS was complete surgical resection. CONCLUSIONS: This retrospective study confirmed the rarity and poor prognosis of RIS in patients with NPC. Complete surgical resection was a significant prognostic factor for survival. The authors concluded that long-term follow-up is necessary for the early detection of RIS in patients with NPC. Cancer 2010;116:5479-86.

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“…Radiation-induced malignancy (RIM) has been recognized since the early 1900s, and is believed to be caused by alterations in cellular DNA (DNA) and ribonucleic acid (RNA). 58,59 The disruption of nucleotide bonds alters protein synthesis and can result in a cancerous transformation if cellular reproduction is modified.…”

Section: Ionizing Radiation and Associated Risk Of Malignancymentioning

confidence: 99%

Pediatric appendicitis: pathophysiology and appropriate use of diagnostic imaging

Brennan

2006

CJEM

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Evaluating children for appendicitis can be extremely difficult, and various strategies have been developed to improve the precision of preoperative diagnosis. Among these, ultrasound and computed tomography (CT) are now widely used but remain controversial. Although CT scanning is superior to ultrasound in terms of diagnostic accuracy for appendicitis, the large dose of ionizing radiation from CT and the risk of subsequent radiation-induced malignancy (RIM) are of particular concern in pediatric patients. This article reviews the literature on the pathophysiology, morbidity and mortality of appendicitis, summarizes the data regarding pediatric imaging in appendicitis, provides a practical approach to imaging for clinicians who evaluate pediatric patients, and makes recommendations for reducing the risk of RIM in pediatric patients. RÉSUMÉIl peut être extrêmement difficile d'évaluer les enfants pour diagnostiquer l'appendicite et diverses stratégies ont été mise au point pour améliorer la précision du diagnostic préopératoire. L'échographie et la tomodensitométrie (TDM), notamment, sont maintenant très répandues, mais elles demeurent controversées. Même si la TDM est supérieure à l'échographie pour ce qui est de l'exactitude du diagnostic d'appendicite, une dose importante de rayonnements ionisants provenant de l'appareil et le risque de tumeur maligne radio-induite (TMRI) subséquente préoc-cupe particulièrement chez les patients en pédiatrie. Dans cet article, les auteurs passent en revue les publications sur la pathophysiologie, la morbidité et la mortalité de l'appendicite, résument les données sur l'imagerie pédiatrique dans les cas d'appendicite, présentent une stratégie pratique d'imagerie pour les cliniciens qui évaluent des patients en pédiatrie et formulent des recommandations afin de réduire le risque de TMRI chez les patients en pédiatrie.

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Radiation‐Induced Malignancy of the Head and Neck

Abstract: C.

Cited by 65 publications

References 9 publications

Radiation‐induced osteosarcomas of the calvarium and skull base

Radiation‐induced osteosarcomas of the calvarium and skull base

Radiation‐induced sarcoma in patients with nasopharyngeal carcinoma

Pediatric appendicitis: pathophysiology and appropriate use of diagnostic imaging

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