Liu Wei-wei, Chen Zhi-hua, Wu Qiu-liang, Wu Guo-hao, Zeng Zong-yuan
Department of Combined Therapy No. 3, Cancer Center of Sun Yat-Sen University, Guangzhou 510060, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2005 Nov;40(11):814-8.
Post irradiation osteosarcoma (PIOS) in patients with nasopharyngeal carcinoma (NPC) is rare and a potential late complication of radiation. We investigate its clinicopathological features and prognosis.
426 cases of bone sarcomas in Cancer Center of Sun Yat-sen University, China between 1964 and 2003 were reviewed retrospectively. Fifteen patients were determined to have PIOS after radiation of NPC. Its prevalence rate, onset time, site, image features, and treatment were described. Kaplan-Meier analysis was used to determine the relative prognostic factors.
In 12 patients undertaken radical surgery, one patient had residual tumor and six patients presented tumor recurrence five to 19 months (mean of nine months) after surgery. All patients survived seven to 41 months with a mean of 18 months. The one-year and two-year survival rates were 60% and 24% respectively. Female patients with large area of tumor bone formation in images had better survival than male patients without or few tumor bone formation. Age, radiation dosage, onset time of PIOS, tumor size, and treatment were probably not significant factors to prognosis.
PIOS in patients with NPC is a high malignant disease and often has poor prognosis. Surgery with pre-and post-operative chemotherapy might be a way to improve its survival.
鼻咽癌（NPC）患者放疗后骨肉瘤（PIOS）罕见，是放疗潜在的晚期并发症。我们对其临床病理特征及预后进行研究。
回顾性分析1964年至2003年中国中山大学肿瘤防治中心收治的426例骨肉瘤患者。15例患者确诊为NPC放疗后发生PIOS。描述其发病率、发病时间、部位、影像特征及治疗情况。采用Kaplan-Meier分析确定相关预后因素。
12例行根治性手术的患者中，1例有肿瘤残留，6例术后5至19个月（平均9个月）出现肿瘤复发。所有患者生存7至41个月，平均18个月。1年和2年生存率分别为60%和24%。影像显示有大面积肿瘤骨形成的女性患者比无或仅有少量肿瘤骨形成的男性患者生存情况更好。年龄、放疗剂量、PIOS发病时间、肿瘤大小及治疗可能不是预后的显著因素。
NPC患者的PIOS是一种高恶性疾病，预后通常较差。术前及术后化疗的手术治疗可能是提高其生存率的一种方法。
