Second primary cancer after intensity-modulated radiotherapy for nasopharyngeal carcinoma: A territory-wide study by HKNPCSG.

Autor: Chow JCH; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong. Electronic address: cch932@ha.org.hk., Tam AHP; The Hong Kong Cancer Registry, Hong Kong Hospital Authority, Hong Kong., Cheung KM; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong., Lee VHF; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong., Chiang CL; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong., Tong M; Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong., Wong ECY; Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong., Cheung AKW; Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong., Chan SPC; Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong., Lai JWY; Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong., Ngan RKC; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong., Ng WT; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong., Lee AWM; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, China., Au KH; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong.
Jazyk: angličtina
Zdroj: Oral oncology [Oral Oncol] 2020 Dec; Vol. 111, pp. 105012. Date of Electronic Publication: 2020 Sep 24.
DOI: 10.1016/j.oraloncology.2020.105012
Abstrakt: Objectives: Long-term risk of second primary cancer (SPC) after definitive intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) remains unclear. This study aims to evaluate the risk, predictive factors and survival impact of SPC in a large territory-wide cohort of NPC survivors in an endemic region.
Materials and Methods: In this multicenter study, consecutive NPC patients (n = 3166) who underwent definitive IMRT in all six public oncology centers in Hong Kong between 2001 and 2010 were included. SPC risks were quantified by standardized incidence ratios (SIRs) and absolute excess risks (AERs) estimated from corresponding age-, sex-, and calendar year-specific population cancer incidence data from the Hong Kong Cancer Registry. Predictive factors and SPC-specific mortality were analyzed.
Results: Over a median follow-up period of 10.8 years, 290 cases of SPC were observed with a crude incidence of 9.2%. Cancer risk in NPC survivors was 90% higher than that in general population [SIR, 1.9; 95% confidence interval (CI), 1.7-2.2], with an AER of 52.1 (95% CI, 36.8-67.3) per 10,000 person-years at risk. Significant excess cancer risks were observed for oral cavity, sarcoma, oropharynx, paranasal sinus, salivary gland, thyroid, skin and lung. Advanced age, smoking, hepatitis B status, and re-irradiation were independent predictive factors. SPC accounted for 9.4% of all deaths among NPC survivors during the study period, and 10-year SPC-specific mortality was 3.4%.
Conclusions: Second cancer risk after IMRT was substantial among NPC patients. SPC impairs long-term survival, and close surveillance is warranted as part of survivorship care.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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