Radiation-induced sarcoma of head and neck: 50 years of experience at a single institution in an endemic area of nasopharyngeal carcinoma in China

Abstract

Radiation-induced sarcoma in the head and neck (RISHN) is a rare condition whose clinical presentation and management remain difficult because of its low incidence. In this retrospective study, we analyzed the symptoms, diagnosis, and the treatment of 16,634 patients with head and neck disease, who received radiotherapy between 1960 and 2010 at the Affiliated Tumor Hospital and its predecessor, Guangxi Medical University, China. Among these patients, 16 with a first tumor of nasopharyngeal carcinoma (NPC) and 1 with squamous carcinoma of the tongue met the criteria of RISHN in the head and neck. Our epidemiological data showed that the incidence of RISHN rose from 0.06 to 0.17% from 1960 to 2010; the 3-year overall survival rate was 19.1%, and 3-year disease-free survival rate was 11.1%. The mean latency (SD) period was 93.2 (33) months. Based on the experiences at our institution, we suggest that RISHN is a rare complication after radiotherapy for head and neck tumors, especially NPC. Owing to its low incidence, it should not be a major factor affecting decisions about radiotherapy. Nevertheless, there may be a possibility of increasing incidence of RISHN after radiotherapy of NPC, as shown in our epidemiological results. Given the poor prognosis of RISHN, this possibility should be taken into serious consideration before determination of high-dose radiotherapy for patients with NPC and other head and neck tumors.

Leiomyosarcomas of the oral cavity: report of a radiation-associated and a metastatic case

“…Nevertheless, using the latest World Health Organization classification of soft and bone tissue tumors, undifferentiated high-grade pleomorphic sarcoma, osteosarcoma, and fibrosarcoma are the most common ones [10,[15][16][17][18][19]. Unlikely, post-radiation LMS is extremely rare [1,12,20] and we could find only five welldocumented cases affecting oral cavity in the English language literature [5,8,[11][12][13].…”

“…In one case, it developed in the buccal mucosa 4 years after radiotherapy for a contralateral squamous cell carcinoma treatment [13]. There are also two additional cases occurring in the hard palate and in mandible in which one developed about 10 years after nasopharyngeal carcinoma radiotherapy treatment in a case series without histopathological slides [19]. Involvement of oropharynx was already described 38 years after radiotherapy for a squamous cell carcinoma of contralateral tonsil [20].…”

“…Five-year survival rates for oral LMS are about 60%, with worst prognosis for jawbone tumors [3,10,11,15,16]. Oral post-radiation LMS prognosis is usually poor and complete surgical excision is the essential treatment used [8,19,20]. Oral metastatic LMS has an overall poor prognosis, and patient usually dies from the disease in a short time interval or remains alive with controlled disease following radiotherapy and/or chemotherapy sessions [6][7][8].…”

Radiation Induced Sarcoma of Hypopharynx: A Case Report

“…However, this low incidence is probably increasing and radiation induced sarcomas are likely to be more frequent. Wei et al (10) report that the incidence of radiation induced sarcomas of head and neck after radiotherapy between 1960 and 1989 is 0.06%. Between 1990 and 2010 this incidence is 0.17% compared to former times, indicating a possible increase in radiation induced sarcomas of head and neck.…”

High-Grade Supraclavicular Soft Tissue Sarcoma as Secondary Malignancy After Successful Treatment of Acute Myeloid Leukemia: Case Report and Literature Review

“…The cumulative incidence for an STS occurring as a second malignancy does not exceed 0.5%. 14,27 Irradiation, including total body irradiation, as a cause of secondary sarcoma has recently been reported 6 ; however, reports of STSs after BMT are still anecdotal. The presented case of a 64-year-old female patient with a rhabdomyosarcomatous lesion in the neck is remarkable for several reasons.…”