TY - JOUR
T1 - Risk of second primary malignancies in head and neck cancer patients treated with definitive radiotherapy
AU - Ng, Sweet Ping
AU - Pollard, Courtney
AU - Kamal, Mona
AU - Ayoub, Zeina
AU - Garden, Adam S.
AU - Bahig, Houda
AU - Gunn, G. Brandon
AU - Frank, Steven J.
AU - Skinner, Heath D.
AU - Phan, Jack
AU - Berends, Joel
AU - Morrison, William H.
AU - Johnson, Jason M.
AU - Ferrarotto, Renata
AU - Sturgis, Erich M.
AU - Mohamed, Abdallah S.R.
AU - Lai, Stephen Y.
AU - Fuller, Clifton D.
AU - Rosenthal, David I.
N1 - Publisher Copyright:
© 2019, Crown.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Second primary malignancy (SPM) may occur after index head and neck cancer (HNC) treatment. This study evaluated the prevalence and outcome of SPM in patients with HNC treated with definitive radiotherapy. Eligible patients include those with index mucosal HNC treated with definitive radiotherapy between 2000 and 2010. SPM was defined as an invasive cancer at a noncontiguous site diagnosed at least 6 months after completion of radiotherapy. Clinical data were collected, and the Kaplan–Meier method was used to estimate overall survival. In total, 1512 patients were studied. The majority of patients had index oropharyngeal cancer (86%). In all, 130 (9%) patients developed a SPM. The risk of SPM increased exponentially with time with 5-, 10-, and 15-year rates of 4, 10, and 25%. Half of SPMs were within the head and neck or thoracic regions. SPM rates were significantly higher (p < 0.0001) in current smokers and former smokers than never smokers with 5-, 10-, and 15-year risk being: never smoker (2, 4, 14%), former smokers with <10-pack year (5, 10, 23%), former smokers with ≥10-pack year (5, 14, 35%), and current smokers (6, 18, 32%). In total, 102 (78%) had subsequent curative-intent therapy. The 5-year overall survival from SPM was 44%. The majority of SPMs were in those with significant smoking history reflecting the same risk factor as for the index mucosal HNC. Nearly one in two patients with SPMs were salvaged underscoring the importance of regular surveillance for SPMs.
AB - Second primary malignancy (SPM) may occur after index head and neck cancer (HNC) treatment. This study evaluated the prevalence and outcome of SPM in patients with HNC treated with definitive radiotherapy. Eligible patients include those with index mucosal HNC treated with definitive radiotherapy between 2000 and 2010. SPM was defined as an invasive cancer at a noncontiguous site diagnosed at least 6 months after completion of radiotherapy. Clinical data were collected, and the Kaplan–Meier method was used to estimate overall survival. In total, 1512 patients were studied. The majority of patients had index oropharyngeal cancer (86%). In all, 130 (9%) patients developed a SPM. The risk of SPM increased exponentially with time with 5-, 10-, and 15-year rates of 4, 10, and 25%. Half of SPMs were within the head and neck or thoracic regions. SPM rates were significantly higher (p < 0.0001) in current smokers and former smokers than never smokers with 5-, 10-, and 15-year risk being: never smoker (2, 4, 14%), former smokers with <10-pack year (5, 10, 23%), former smokers with ≥10-pack year (5, 14, 35%), and current smokers (6, 18, 32%). In total, 102 (78%) had subsequent curative-intent therapy. The 5-year overall survival from SPM was 44%. The majority of SPMs were in those with significant smoking history reflecting the same risk factor as for the index mucosal HNC. Nearly one in two patients with SPMs were salvaged underscoring the importance of regular surveillance for SPMs.
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U2 - 10.1038/s41698-019-0097-y
DO - 10.1038/s41698-019-0097-y
M3 - Article
C2 - 31583278
AN - SCOPUS:85086935566
SN - 2397-768X
VL - 3
JO - npj Precision Oncology
JF - npj Precision Oncology
IS - 1
M1 - 22
ER -