Radiation-induced sarcoma in patients with nasopharyngeal carcinoma: a single-institution study.
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).


METHODS
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.
Xi
Mian
M
Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, China.
Liu
Meng-Zhong
MZ
Wang
Hai-Xia
HX
Cai
Ling
L
Zhang
Li
L
Xie
Chun-Fang
CF
Li
Qiao-Qiao
QQ
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012509:Sarcoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome