Treatment of second primary malignant tumor induced by radiotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of a second primary malignant tumor induced by previous radiotherapy.</p><p><b>METHODS</b>From March 1970 to March 1997, 108 nasopharyngeal cancer (NPC) patients who developed a second primary malignant tumor induced by radiotherapy were treated. There were squamous carcinoma 43 (39.8%), sarcoma 26 (24.1%), malignant fibrous histiocytoma 14 (13.0%), adenoid cystic carcinoma 12 (11.1%), thyroid papillary adenocarcinoma 8 (7.4%) and malignant melanoma 5 (4.6%). Fifty patients underwent operation, 32 received radiotherapy, 18 received chemotherapy and 8 received operation combined with chemotherapy.</p><p><b>RESULTS</b>The 3- and 5-year tumor-free survival rates were 64.0% and 36.0% in the operation group. They were 34.4% and 18.8% in the radiotherapy group.</p><p><b>CONCLUSION</b>Surgery, if not contra-indicated, is the first choice for the second primary malignant tumor induced by radiotherapy. Aggressive treatment for these patients is, hence, indicated clinically.</p>

Effect of p53 expression in the primary lesion and the surgical margin on the postoperative radiotherapy for laryngeal squamous carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the correlation between prognosis and p53 expression in primary lesion and the surgical margin of laryngeal squamous cell carcinoma (SCC) as an indication of postoperative radiotherapy.</p><p><b>METHODS</b>Sixty-seven laryngeal SCC with pathological negative margin were analyzed retrospectively. Immunohistochemical method was used to detect the expression of p53.</p><p><b>RESULTS</b>The p53 positive rates in the primary tumor and the surgical margin were 19.4% (13/67) and 50.7% (34/67). In p53 positive primary tumor group, the survival rate was higher in patients who received postoperative radiotherapy than those without (60.6% vs 20.0%, P = 0.000 5) and the recurrent rate was just the reverse (42.1% vs 93.3%, P = 0.002), though these differences were not significant in p53 negative primary tumor group (87.5% vs 94.1%, P = 0.409 6; 25.0% vs 5.9%, P = 0.175). The recurrent rate and survival rate between patients with and without postoperative radiotherapy did not show any significant difference either in p53 positive surgical margin group (47.4% vs 20.0%, P = 0.378 1; 62.5% vs 80.0%, P = 1.0) or p53 negative ones (84.9% vs 66.6%, P = 0.074 3; 20.6% vs 40.7%, P = 0.248).</p><p><b>CONCLUSION</b>Postoperative radiotherapy should be given to patients with p53 positive primary laryngeal cancer. But those who are pathologically margin negative but p53 positive should not be taken, at least for the present, as candidates for postoperative radiotherapy.</p>