Treatment outcomes of postradiation second head and neck malignancies managed by a multidisciplinary approach

Head Neck. 2015 Jun;37(6):815-22. doi: 10.1002/hed.23674. Epub 2014 Jun 19.

Abstract

Background: The purpose of this study was to report on the treatment outcomes of patients with postradiation second head and neck malignancies.

Methods: Fifty-seven consecutive patients with postradiation second malignancy were reviewed. Progression-free survival (PFS), overall survival (OS), and prognostic factors were analyzed.

Results: Mean time interval between first course of radiation therapy to the development of postradiation second malignancy was 13.2 years. Median PFS and OS for the whole group were 12.0 and 67.0 months, respectively. Postradiation sarcoma conferred a worse PFS (p = .003) and OS (p = .001) as compared to postradiation carcinoma. Multivariate analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status ≥3 (p = .034), postradiation sarcoma (p = .007), and lack of radical surgery (p = .044) are prognostic of PFS, whereas postradiation sarcoma (p = .002), lack of postprogression surgery (p < .001), and lack of postprogression systemic therapy (p = .011) were prognostic factors of OS.

Conclusion: Treatment outcomes of postradiation second malignancy seemed promising under a multidisciplinary management.

Keywords: multidisciplinary; postradiation malignancies; prognostic factors; treatment outcomes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Biopsy, Needle
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms, Radiation-Induced / diagnosis*
  • Neoplasms, Radiation-Induced / mortality
  • Neoplasms, Radiation-Induced / therapy
  • Neoplasms, Second Primary / diagnosis*
  • Neoplasms, Second Primary / mortality*
  • Neoplasms, Second Primary / therapy
  • Positron-Emission Tomography / methods
  • Prognosis
  • Retrospective Studies
  • Statistics, Nonparametric
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Young Adult