Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Cancer. 2011 May 15;117(10):2120-6. doi: 10.1002/cncr.25734. Epub 2010 Nov 29.
Although a rare complication of ionizing radiation, radiation-induced osteosarcoma is now more frequently recognized as radiation therapy has become common and cancer survival has increased. To date, publications on radiation-induced osteosarcoma of the cranium are limited to a few small series and case reports.
Data from 175 patients with a history of sarcoma of the head at The University of Texas M. D. Anderson Cancer Center from 1975 to 2007 were reviewed to identify patients with radiation-induced osteosarcoma. The diagnostic criteria were: 1) osteosarcoma arose within the previously irradiated field; 2) new sarcoma was histologically distinct from the original neoplasm; 3) no evidence of new sarcoma at the time of radiation; and 4) distinct latency period could be recognized. Frequencies and descriptive statistics were obtained for the various characteristics under study.
The authors identified 16 patients with radiation-induced osteosarcoma of the cranium at their institution. The average age at diagnosis was 35 years. The median latency period was 12.5 years. Nine patients had skull base tumors, and 7 had calvarial tumors. Of the 14 patients treated surgically, 86% developed local recurrence. The median survival time was 29 months, and the 5-year survival rate was 29.6%.
The authors report the largest series of cranial radiation-induced osteosarcoma. Although radiation-induced osteosarcoma is an uncommon but dire complication of radiotherapy, its incidence will probably increase in the future as the frequency of radiation treatment and cancer survival increase. These tumors are locally aggressive, and despite aggressive surgical and medical management, they have a high rate of local recurrence and mortality.
虽然电离辐射是一种罕见的并发症，但随着放射治疗的普及和癌症存活率的提高，辐射诱发的骨肉瘤现在更为常见。迄今为止，有关颅部辐射诱发骨肉瘤的出版物仅限于少数小系列和病例报告。
回顾了 1975 年至 2007 年在德克萨斯大学 MD 安德森癌症中心治疗的 175 例头部肉瘤患者的数据，以确定患有辐射诱发骨肉瘤的患者。诊断标准为：1）骨肉瘤发生在先前照射的区域内；2）新肉瘤在组织学上与原始肿瘤不同；3）在放疗时没有新肉瘤的证据；4）可以识别出明显的潜伏期。对所研究的各种特征进行了频率和描述性统计。
作者在该机构发现了 16 例颅部辐射诱发骨肉瘤患者。诊断时的平均年龄为 35 岁。中位潜伏期为 12.5 年。9 例患者有颅底肿瘤，7 例患者有颅骨肿瘤。在接受手术治疗的 14 例患者中，86％发生局部复发。中位生存时间为 29 个月，5 年生存率为 29.6％。
作者报告了最大系列的颅部辐射诱发骨肉瘤。尽管辐射诱发的骨肉瘤是放射治疗的一种罕见但严重的并发症，但随着放射治疗的频率和癌症存活率的提高，其发病率可能会增加。这些肿瘤具有很强的局部侵袭性，尽管采用了积极的手术和药物治疗，但局部复发和死亡率仍然很高。
