Liu Chao, Liao Lieqiang, Wu Guoying, Yan Honghong, Chen Xiaoqi, Wang Chao, Zheng Xiajing, Zeng Ziyi, Zhao Zheng, Wu Di, Liu Xuekui
School of Stomatology, Jilin University, Changchun 130041, Jilin, PR China.
Department of Otolaryngology Head and Neck Surgery, The First People's Hospital of Foshan, Foshan, Guangdong, PR China.
Oral Oncol. 2020 Jun 27;109:104863. doi: 10.1016/j.oraloncology.2020.104863.
The increasing occurrence of radiation-induced second primary squamous cell carcinoma of the oral cavity (RISCCO) after radiotherapy for nasopharyngeal carcinoma (NPC) has become a noteworthy complication that can influence long-term survival. This study aimed to analyze the associations of clinicopathologic characteristics with prognostic factors among patients who developed RISCCO after radiotherapy for NPC.
A total of 41,446 NPC patients admitted to Sun Yat-sen University Cancer Center (SYSUCC) between August 1989 and January 2019 were reviewed. Among these patients, 88 RISCCO patients who satisfied the inclusion criteria were included in the study.
During our study, the incidence of RISCCO after radiotherapy was 0.21% (88/41,446) among NPC patients at SYSUCC. The latency period ranged from 1.0 to 34.0 years (median, 9.0 years), and the latency of RISCCO was notably shorter for patients who received intensity-modulated radiation therapy than that for patients who received conventional radiotherapy using cobalt-60 or 6-MV X-rays (median, 4.0 years vs. 11.0 years, P = 0.013). The 1-, 3-, and 5-year overall survival (OS) rates for the entire cohort of 88 patients were 79.0%, 46.6%, and 35.2%, respectively. The 5-year OS rate for the 79 patients who received treatment was 45.7%, and the 5-year OS rate for the 9 patients who refused treatment was 0%. T classification and surgery were identified as independent prognostic factors associated with a high OS rate.
Surgery as the first-choice treatment may improve survival and prognosis. A long-term follow-up is needed for early detection of RISCCO in NPC patients.
鼻咽癌（NPC）放疗后口腔放射性诱导的第二原发性鳞状细胞癌（RISCCO）发生率不断增加，已成为一种值得关注的并发症，可能影响长期生存。本研究旨在分析NPC放疗后发生RISCCO患者的临床病理特征与预后因素之间的关联。
回顾了1989年8月至2019年1月在中山大学肿瘤防治中心（SYSUCC）收治的41446例NPC患者。在这些患者中，88例符合纳入标准的RISCCO患者被纳入研究。
在我们的研究中，SYSUCC的NPC患者放疗后RISCCO的发生率为0.21%（88/41446）。潜伏期为1.0至34.0年（中位数为9.0年），接受调强放疗的患者RISCCO潜伏期明显短于接受钴-60或6兆伏X射线传统放疗的患者（中位数分别为4.0年和11.0年，P = 0.013）。88例患者全队列的1年、3年和5年总生存率（OS）分别为79.0%、46.6%和35.2%。接受治疗的79例患者的5年OS率为45.7%，拒绝治疗的9例患者的5年OS率为0%。T分类和手术被确定为与高OS率相关的独立预后因素。
手术作为首选治疗方法可能改善生存和预后。NPC患者需要长期随访以早期发现RISCCO。
