title: Treatment outcomes of postradiation second head and neck malignancies managed by a multidisciplinary approach.
abstract: BACKGROUND
  The purpose of this study was to report on the treatment outcomes of patients with postradiation second head and neck malignancies.
  
  
  METHODS
  Fifty-seven consecutive patients with postradiation second malignancy were reviewed. Progression-free survival (PFS), overall survival (OS), and prognostic factors were analyzed.
  
  
  RESULTS
  Mean time interval between first course of radiation therapy to the development of postradiation second malignancy was 13.2 years. Median PFS and OS for the whole group were 12.0 and 67.0 months, respectively. Postradiation sarcoma conferred a worse PFS (p = .003) and OS (p = .001) as compared to postradiation carcinoma. Multivariate analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status ≥3 (p = .034), postradiation sarcoma (p = .007), and lack of radical surgery (p = .044) are prognostic of PFS, whereas postradiation sarcoma (p = .002), lack of postprogression surgery (p < .001), and lack of postprogression systemic therapy (p = .011) were prognostic factors of OS.
  
  
  CONCLUSIONS
  Treatment outcomes of postradiation second malignancy seemed promising under a multidisciplinary management.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Joseph
authors.initials: J
authors.lastname: Chung
authors.affiliation: Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Victor
authors.initials: V
authors.lastname: Lee
authors.affiliation: Division of Otorhinolaryngology, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Raymond
authors.initials: R
authors.lastname: Tsang
authors.affiliation: Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Chan
authors.affiliation: Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Dora L W
authors.initials: DL
authors.lastname: Kwong
authors.affiliation: Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Ka-On
authors.initials: KO
authors.lastname: Lam
authors.affiliation: Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Henry C K
authors.initials: HC
authors.lastname: Sze
authors.affiliation: Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: To-Wai
authors.initials: TW
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: multidisciplinary; postradiation malignancies; prognostic factors; treatment outcomes