Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, China.
Cancer. 2010 Dec 1;116(23):5479-86. doi: 10.1002/cncr.25329. Epub 2010 Aug 16.
The increasing incidence of radiation-induced sarcoma (RIS) has become a significant problem that can limit long-term survival. The objective of the current study was to analyze the clinicopathologic characteristics, treatment outcomes, and prognostic factors of RIS after radiotherapy for nasopharyngeal carcinoma (NPC).
Institutional electronic medical records of patients with NPC who received definitive radiotherapy between February 1964 and 2003 were reviewed. Fifty-three patients who developed RIS and fulfilled the study criteria were included.
The median follow-up after a diagnosis of RIS was 15.5 months (range, 0.4-90.3 months), and the median latency between radiotherapy for NPC and an RIS diagnosis was 9.3 years (range, 3.2-26.6 years). Fibrosarcoma was the most frequent histologic type observed, followed by osteosarcoma, and malignant fibrous histiocytoma. The 3-year overall survival (OS) rate for 49 patients who received treatment was 32.4%, and the median survival was 21.2 months (95% confidence interval, 8.7-33.8 months). The median OS was 41.3 months, 8.4 months, and 11 months for the complete resection group, the incomplete resection group, and the chemotherapy group, respectively (P<.0001). The only independent predictive factor that was associated with better OS was complete surgical resection.
This retrospective study confirmed the rarity and poor prognosis of RIS in patients with NPC. Complete surgical resection was a significant prognostic factor for survival. The authors concluded that long-term follow-up is necessary for the early detection of RIS in patients with NPC.
放射诱导肉瘤（RIS）的发病率不断上升，已成为限制长期生存的重要问题。本研究旨在分析鼻咽癌（NPC）放疗后 RIS 的临床病理特征、治疗结果和预后因素。
回顾性分析 1964 年 2 月至 2003 年期间接受根治性放疗的 NPC 患者的机构电子病历。符合研究标准的 53 例 RIS 患者被纳入本研究。
RIS 诊断后的中位随访时间为 15.5 个月（范围：0.4-90.3 个月），NPC 放疗与 RIS 诊断之间的中位潜伏期为 9.3 年（范围：3.2-26.6 年）。组织学类型以纤维肉瘤最常见，其次是骨肉瘤和恶性纤维组织细胞瘤。49 例接受治疗的患者 3 年总生存率（OS）为 32.4%，中位生存时间为 21.2 个月（95%置信区间：8.7-33.8 个月）。完全切除组、不完全切除组和化疗组的中位 OS 分别为 41.3 个月、8.4 个月和 11 个月（P<.0001）。唯一与 OS 相关的独立预后因素是完全手术切除。
本回顾性研究证实了 NPC 患者 RIS 的罕见性和不良预后。完全手术切除是生存的显著预后因素。作者得出结论，长期随访对于 NPC 患者 RIS 的早期发现是必要的。
