Radiation-induced cancers of the pharynx and larynx: a study of five clinical cases.
Radiation-induced cancer, a rare clinical entity, is often difficult to diagnose and manage. This study reports a series of five cases of radiocarcinogenesis of the pharynx and/or larynx that developed after external radiotherapy. The primary lesion was diagnosed at a mean age of 50 years (+/-12.9) and the radiation-induced cancer at a mean age of 59 years (+/-13.1), giving a latent period of 9 years (+/-3.7). Analysis of gammagraphic records indicated that four of the patients had developed a secondary tumour in the penumbra of irradiation fields. In these zones, the delivered dose was between 20 and 80% of the prescribed dose, corresponding to an estimated cumulative mean dose of 14.1-56.3 Gy. These results are compared with data in the literature to determine the diagnostic criteria for radiation-induced cancer, possible predisposition (genetic or acquired) and the dose effect.
Malard
O
O
Service de clinique O.R.L. et de chirurgie cervico-faciale, CHU de Nantes, Hotel-Dieu, Place A. Ricordeau, BP 1005, 44093 Nantes Cedex 01, France. omalard@sante.univ-nantes.fr
Toquet
C
C
Gayet-Delacroix
M
M
Bordure
P
P
Beauvillain de Montreuil
C
C
Bardet
E
E
D000328:Adult; D000368:Aged; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects; D012509:Sarcoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology