Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Int J Oral Maxillofac Surg. 2024 Jan;53(1):11-17. doi: 10.1016/j.ijom.2023.05.004. Epub 2023 May 20.
This study was performed to analyse the age-specific characteristics of head and neck second primary malignancies (SPMs) in patients treated for nasopharyngeal carcinoma (NPC). The medical records of 56 NPC patients diagnosed with head and neck SPMs were reviewed retrospectively. Patients < 45 years old at NPC diagnosis were assigned to the younger group and those ≥ 45 years of age were assigned to the older group. The treatment of the index NPC, latency period, pathological TNM stage, survival status, and SPM subsite were analysed. Patients in the older group were found to have a shorter median latency period than those in the younger group: 8.5 years (range 3-20 years) versus 11 years (range 1-30 years) (P = 0.015). The proportion of SPMs in the jaw was significantly higher in the younger group (P = 0.002). Patients in the younger group receiving radiotherapy with chemotherapy had a shorter latency period (P = 0.003) and higher risk of developing SPMs in the jaw (P = 0.036) than those receiving radiotherapy alone. A long-term and age-dependent regular customised follow-up strategy for NPC is necessary for the prevention and early detection of head and neck second primary malignancies.
本研究旨在分析治疗鼻咽癌（NPC）后发生头颈部第二原发恶性肿瘤（SPM）的患者的年龄特异性特征。回顾性分析了 56 例诊断为头颈部 SPM 的 NPC 患者的病历。NPC 诊断时年龄<45 岁的患者归入年轻组，年龄≥45 岁的患者归入老年组。分析了 NPC 指数的治疗、潜伏期、病理 TNM 分期、生存状况和 SPM 亚部位。与年轻组相比，老年组患者的中位潜伏期更短：8.5 年（范围 3-20 年）比 11 年（范围 1-30 年）（P=0.015）。年轻组中下颌 SPM 的比例明显更高（P=0.002）。与单纯放疗相比，接受放化疗的年轻组患者潜伏期更短（P=0.003），发生下颌 SPM 的风险更高（P=0.036）。对于 NPC，需要制定长期的、基于年龄的个体化定制随访策略，以预防和早期发现头颈部第二原发恶性肿瘤。
