Outcomes and Prognostic Factors of Post-irradiation and de novo Sarcomas of the Head and Neck: A Histologically Matched Case-Control Study

Yeang, Ming Sheng; Tay, Kaijun; Ong, Whee Sze; Thiagarajan, Anuradha; Tan, Daniel Shao-Weng; Ha, Tam; Teo, Patrick Tze-Hern; Soo, Khee‐Chee; Tan, Hiang Khoon; Iyer, N. Gopalakrishna

doi:10.1245/s10434-013-2979-5

Cited by 35 publications

(28 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most common symptoms, essentially related to the site of occurrence of the tumor itself, are: asymmetry of the HN region, pain, trismus, epistaxis, diplopia, jaw numbness, and dysphagia, while sometimes RIS may be misdiagnosed as osteoradionecrosis ( 23 , 26 ). Furthermore, the overall features of RISHN and de novo sarcomas make it impossible to define a clear distinction between these two entities: in fact, median age, gender ratio, median tumor size, and tumor grade are similar between RIS and osteoradionecrosis ( 27 ).…”

Section: Clinical and Radiological Featuresmentioning

confidence: 99%

“…RIS are historically considered highly aggressive tumors, characterized by poor prognosis. Yeang et al found an age more than 50, smoking history, tumor size, and grading to be significant negative prognosticators ( 27 ). However, most of the reports analyzed RISHN as if they were a single entity, even though, indeed, they include a wide range of possible histotypes, as mentioned above.…”

Section: Treatment and Prognosismentioning

confidence: 99%

See 1 more Smart Citation

Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature

et al. 2018

View full text Add to dashboard Cite

In the last decades, radiotherapy (RT) has become one of the cornerstones in the treatment of head and neck (HN) malignancies and has paralleled an increase in long-term patient survival. This lead to a concomitant increase in the incidence of radiation-induced sarcomas (RIS) of the irradiated field, with an annual rate up to 0.17%. The new techniques of irradiation do not seem to influence the risk of RIS of the HN (RISHN), which mainly develop within the middle-dose field. The median latency of RISHN after RT is 10–12 years and osteosarcoma is the most represented histotype, even though there is a high variability in time of occurrence and histological features observed. There is no clear evidence of predisposing factors for RISHN, and genetic findings so far have not revealed any common mutation. Early clinical diagnosis of RISHN is challenging, since it usually occurs within fibrotic and hardened tissues, while radiological findings are not pathognomonic and able to differentiate them from other neoplastic entities. Given the highly aggressive behavior of RISHN and its poor sensitivity to chemotherapy, radical surgery is the most important prognostic factor and the only curative option at present. Nevertheless, the anatomy of the HN district and the infiltrative nature of RIS do not always allow radical intervention. Therefore, a wise integration with systemic therapy and, when feasible, re-irradiation should be performed. Future findings in the genomic features of RISHN will be crucial to identify a possible sensitivity to specific drugs in order to optimize a multimodal treatment that will be ideally complementary to surgery and re-irradiation.

show abstract

Section: Clinical and Radiological Featuresmentioning

confidence: 99%

Section: Treatment and Prognosismentioning

confidence: 99%

Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature

et al. 2018

View full text Add to dashboard Cite

show abstract

“…As with other sarcomas, the risk of disease increases in genetic predisposition syndromes, which include Li-Fraumeni syndrome, neurofibromatosis type I, retinoblastoma, as well as previous exposure to irradiation. In patients infected with HIV (human immunodeficiency virus) and herpes virus (human herpes virus 8), the risk of developing Kaposi's sarcoma increases [11][12][13], which due to the peculiarity of conduct and the extremely rare occurrence is not the subject of this study.…”

Section: Introductionmentioning

confidence: 99%

Recommendations in management of head and neck sarcomas

et al. 2019

View full text Add to dashboard Cite

Sarcomas of the head and neck are rare malignant tumours with incidence 2% of head and neck cancers, 30% of all sarcomas in children and 4-10% of sarcomas in adults. The most common sarcoma in children is rhabdomyosarcoma (RMS) and Ewing sarcoma (ES), in contrary in elderlies there is angiosarcoma; osteosarcoma and chondrosarcoma are the most common bone tumours in head and neck. The typical symptoms are: painless tumour in the head and neck region, difficulty with speaking, hoarseness, dysphagia, nasal obturation, or dysfunction of cranial nerves. The key point of diagnostics is magnetic resonance and computed tomography of the primary tumour. The treatment of patients with sarcoma should be carried out in referral centers, where experienced multidisciplinary team proceed the surgical removal of a primary tumour with reconstructive surgery as well as perioperative systemic therapy (in selected cases). The recommendations were developed by the Head and Neck Sarcoma Group of the Polish Registry of Bone Tumors.

show abstract

“…Head and neck sarcomas are relatively rare clinical entities, 10% of sarcomas in adults originates in the head and neck region accounting for 1% of all head and neck malignancies, radiation induced head and neck sarcomas are even more rare and the incidence range from 0.16 to 0.3%. (1,2) Radiation is the integral part of head and neck cancer management but has some deleterious effect including development of second malignancy at the site of exposure. A squamous cell cancer is the commonest histologic subtype of radiation-induced malignancy in the head and neck region followed by radiation induced sarcoma(RIS) which consists of 12% of radiation induced malignancy and estimated life time risk is of 0.03 to 0.3% in post-irradiated patients.…”

Section: Introductionmentioning

confidence: 99%

“…(3) Though there is no side predilection for RIS in head and neck region more than 80% of them developed in survivor of Nasopharyngeal carcinoma. (2) We present the rare case of RIS of floor of the mouth who was treated for squamous cell carcinoma of right lateral border of tongue by primary surgery followed by adjuvant Radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Radiation induced sarcoma of head and neck: A rare entity

Paudel

Gundale

Rajinikanth

et al. 2018

AAMS

View full text Add to dashboard Cite

Sarcoma are rare in head and neck region and radiation induced sarcoma (RIS) are even rare and poses challenges for diagnosis and proper management. We report a case of 38 year old male who was treated for carcinoma of right lateral border of tongue with surgery and radiotherapy, and presented with rapidly progressing mass in right floor of mouth after 4 years. Biopsy and imaging confirmed the diagnosis of radiation induced sarcoma and was managed with wide local excision of mass with hemimandibulectomy with reconstruction by pectoralis major mayocutaneous flap. Patient completed the follow up of one and half year and doing well. RIS of head and neck is rare entity and demands multidisciplinary involvement of head and neck, neuro, reconstructive surgeons, radiation oncologists and medical oncologists for optimal management. Though it has poor prognosis but properly managed patients will have the good quality of life.

show abstract

Outcomes and Prognostic Factors of Post-irradiation and de novo Sarcomas of the Head and Neck: A Histologically Matched Case-Control Study

Abstract: In our cohort, PIS constituted 28% of head and neck sarcomas. Poorer prognosis traditionally associated with PIS compared with DN was not seen amongst patients treated with curative intent.

Cited by 35 publications

References 16 publications

Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature

Radiation-Induced Sarcoma of the Head and Neck: A Review of the Literature

Recommendations in management of head and neck sarcomas

Radiation induced sarcoma of head and neck: A rare entity

Contact Info

Product

Resources

About