title: Chronological shifts and changing causes of death after radiotherapy for early-stage oral cancer.
abstract: BACKGROUND
  Following recent improvements in the curability of oral cancer, chronological shifts and changes in the causes of death after treatment have been observed. We conducted a review of the post-treatment causes of death following radiotherapy for oral cancers.
  
  
  METHODS
  The medical records of 966 patients with early-stage (stage I and II) oral cancer treated at our institute between 1980 and 2001 were reviewed, and the chronological shifts and changes in the causes of death after radiotherapy were assessed.
  
  
  RESULTS
  Of the 966 patients enrolled in this study, 365 have died to date. Two hundred and eleven patients died of their primary malignancy; 193 of these deaths occurred within 5 years of treatment for the primary oral cancer. The second most frequent cause of death was second primary cancer (n = 90). Twenty-three patients with head and neck cancers and 18 patients with esophageal cancers died within 10 years of radiotherapy, and six patients with lung cancers died after more than 10 years.
  
  
  CONCLUSIONS
  Within the first 5 years following treatment, the major cause of death was the primary oral cancer. After 5-10 years, a second primary cancer, such as head and neck cancer or esophageal cancer, became the leading cause of death. Over a 10-year period, the proportion of deaths from a second primary cancer in the lung was significant. We have demonstrated that there are chronological shifts and changes in the causes of death following treatment for early-stage oral cancer.
authors: Department of Diagnostic Radiology and Oncology, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8519, Japan, rina_rina925@yahoo.co.jp.
authors: Rina
authors: R
authors: Fujisawa
authors: Hitoshi
authors: H
authors: Shibuya
authors: Naoki
authors: N
authors: Harata
authors: Keiko
authors: K
authors: Yuasa-Nakagawa
authors: Kazuma
authors: K
authors: Toda
authors: Keiji
authors: K
authors: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
references: Oral Oncol. 2011 Nov;47(11):1085-91
references: 21840751
references: Arch Otolaryngol Head Neck Surg. 2011 Nov;137(11):1094-9
references: 22106232
references: Cancer. 2002 Apr 1;94(7):2007-14
references: 11932903
references: Oral Oncol. 2012 Feb;48(2):186-91
references: 21996543
references: Int J Clin Oncol. 2009 Feb;14(1):2-6
references: 19225918
references: Cancer. 1994 Apr 15;73(8):2038-41
references: 7512440
references: Int J Radiat Oncol Biol Phys. 1999 Jul 1;44(4):767-75
references: 10386633
references: Cancer. 2012 Jan 1;118(1):101-11
references: 21717431
references: Br J Radiol. 2005 Nov;78(935):1028-33
references: 16249604
references: Int J Radiat Oncol Biol Phys. 1993 Apr 30;26(1):51-8
references: 8482630
references: Acta Oncol. 2012 May;51(5):645-52
references: 22229748
references: Head Neck Oncol. 2012 Mar 12;4:6
references: 22409767
references: J Cancer Res Ther. 2009 Jul-Sep;5(3):192-7
references: 19841561
references: Radiother Oncol. 2003 Aug;68(2):129-35
references: 12972307