Second primary cancer after intensity-modulated radiotherapy for nasopharyngeal carcinoma: A territory-wide study by HKNPCSG
| Autor: | Wai Tong Ng, Jessica W.Y. Lai, Edwin C.Y. Wong, Anne W.M. Lee, James C.H. Chow, Kwok-Hung Au, Victor Ho-Fun Lee, Sunny P.C. Chan, Roger Kai Cheong Ngan, Macy Tong, Alice K.W. Cheung, Anthony H.P. Tam, K.M. Cheung, Chi-Leung Chiang |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty animal structures Adolescent medicine.medical_treatment Population Risk Assessment Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine otorhinolaryngologic diseases Humans Medicine 030223 otorhinolaryngology education Aged Aged 80 and over education.field_of_study Nasopharyngeal Carcinoma Smokers business.industry Incidence Incidence (epidemiology) Cancer Nasopharyngeal Neoplasms Neoplasms Second Primary Middle Aged medicine.disease Cancer registry Radiation therapy Nasopharyngeal carcinoma 030220 oncology & carcinogenesis Cohort Hong Kong Female Radiotherapy Intensity-Modulated Sarcoma Oral Surgery business |
| Zdroj: | Oral Oncology. 111:105012 |
| ISSN: | 1368-8375 |
| DOI: | 10.1016/j.oraloncology.2020.105012 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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